Vesnin V. Optimization of surgical treatment of tuberculous spondylitis (clinical - experimental study)

Tuberculous spondylitis (TS) in the structure of bone and articular tuberculosis in adults ranks a leading place, encountering 40-61.5 % of cases, and disability due to TS reaches 53.5 %. In the current methods of treatment, the duration of stay of patients with limited forms of tuberculous spondylitis in the hospital is 8-10 months, and the formation of the bone block between the resected bodies of the vertebrae ends in 1.5-2 years. During this period, patients are Group I-II disabled. It is necessary to search for ways to significantly reduce the preoperative preparation of patients, as well as the possibility of their early activation after surgery, which will allow a significant reduction in the inpatient stage of treatment. Thus, new tactics of TS treatment in the main group in comparison with the traditional standards of surgical interventions (control group, n = 30) allowed: 1) to avoid the progression of TS, the development of lower paraplegia (p < 0.05) and the complications associated with the metal structure (fractures, autograft displacement, cage) (p < 0.05), in the postoperative period; 2) to substantially improve the treatment efficiency by increasing the excellent results (46.7 % and 26.7 % respectively) and reducing the satisfactory (13.3 % and 23.3 % respectively) and unsatisfactory (0.0% and 10.0% respectively, p < 0,05) results according to the generally accepted score scale by E.V. Ulrich, O.Yu. Mushkin (2004); 3) reduce the inpatient stage of treatment (96 ± 12 and 190 ± 21 bed-days, respectively) (p <0,001)