Golka G. Modern approaches to diagnosis and treatment of tuberculous spondylitis

3. The object of the research: tuberculous spondylitis (TS). The purpose of the research: to work out a complex system of early diagnosis and treatment of patients with tuberculous spondylitis aimed at a higher efficacy of the treatment. The methods of the research: clinical, radial, laboratory, including pathomorphological, immunological, statistic ones. New knowledge was acquired about a dependence of the severity of neurological disorders upon the level of affection of the spine and the value of destruction of the vertebrae. Clinical and pathomorphological manifestations of the disease depending upon immunological indices were characterized, and on this basis new approaches to the diagnosis and treatment of the patients were worked out. The role and significance of modern radial methods of diagnosis of TS (sonographic diagnosis, computed tomography, magnetic resonance imaging) were studied. The most typical kinds of destruction of the vertebrae in TS were isolated on the basis of the made analysis of results of the radial methods of examination. A complex staged technique for treating TS patients with regard for the form of a tuberculous process, presence of complications and a concomitant pathology was worked out. A possibility and expediency of using ceramic implants saturated with preparations of a directed effect in surgical treatment of tuberculous lesions of the spine was grounded. Also a technique of low-invasive surgical interventions was worked out. Clinical-radiological data and results of the treatment of 175 TS patients with conservative and surgical methods were analysed. A highly effective technique of the diagnosis and treatment of TS was created, it making possible to improve the results of treating this severe category of patients. A created diagnostic algorithm and a differential-diagnostic table of TS make it possible to avoid mistakes which cause unsatisfactory results in solving problems of the diagnostic, prognostic and medical kinds. The created technique was applied to clinical practice at the Kharkov Regional Traumatology Hospital, Sytenko Research Institute of Spine and Joints Pathology of the Academy of Medical Sciences of Ukraine, Kharkov Regional Tuberculosis Hospital No. 1, as well as to the educational process at the departments of Kharkov Medical Academy of Post-Graduate Training and Kharkov State Medical University. Traumatology and Orthopaedics