[Surgical treatment of spinal tuberculosis in aged].
OBJECTIVE
To investigate perioperative features and results of surgical treatment of spinal tuberculosis in aged.


METHODS
Review the clinical data of 36 aged with spinal tuberculosis from May 1998 to June 2005 retrospectively. The average age was 70.2 years. The sites of infection included 3 cervical, 9 thoracic, 13 thoracolumbar and 11 lumbar. 28 patients suffered 1 or more complications at least and among of them, there were 18 patients have cerebral or heart vascular disease, 16 patients have diabetes mellitus. Before operation, all patients consulted with internal stuff for the proper treatment of concomitant disease. The surgical procedures include: CT guided percutaneous catheter drainage in 3 patients, anterior debridement and bony grafting with anterior instrumentation fixation in 12 patients, anterior debridement and bony grafting with posterior fixation in 5 patients, posterolateral costotransversectomy debridement and interbody fusion with posterior fixation in 7 patients, posterior debridement and posterior fixation in 9 patients. The mean followed-up period was 3 years and 10 months (from 1.5 to 6 years).


RESULTS
One died at two week after the operation. Tuberculous infection was controlled in other patients and no recurrence. Two patients died because of myocardial infarction and cerebral hemorrhage respectively at 1.5 and 2.5 years after operation. Bone fusion was achieved in 31 patients. The deformity was partial corrected at the final follow-up. Among 20 cases with neurologic deficit, 11 cases were completely recovered, 5 cases were partly improved.


CONCLUSIONS
If the associated disorders and postoperative complications are properly handled, aged patients can endure surgical treatment for spinal tuberculosis. Instrumentation fixation provides adequate stability and promote recovery.
Xue
Hai-bin
HB
Department of Orthopaedic, the Second Hospital of People's Liberation Army General Hospital, Beijing 100091, China. tornatorex@sina.com.cn
Ma
Yuan-zheng
YZ
Chen
Xing
X
Li
Hong-wei
HW
Cai
Xiao-jun
XJ
Guo
Li-xin
LX
Peng
Wei
W
D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000601:surgery*