[Complications of the anterior surgical approach for thoracolumbar spine tuberculosis: causes and countermeasures].
OBJECTIVE
To assess the effect of the anterior surgical approach for thoracolumbar spine tuberculosis and analyzed the causes of the surgical complications and the countermeasures.


METHODS
From Jan 1996 to Dec 2005, 120 patients with thoracolumbar spine tuberculosis underwent operations through the anterior approach either following the primary diagnosis (115 cases) or for recurrence (5 cases).


RESULTS
Intraoperative pleural rupture occurred in 4 cases, and rupture of the external iliac vein occurred 1 case. Three patients had damages of the T12 dorsal ramus. One patient developed venous embolism of the lower extremity after the operation, two had paralytic ileus and 1 had false diabetes insipidus. Of the 5 recurrent patients, 1 died due to alcoholic cirrhosis and acute liver failure, 1 received a third operation for loosened internal fixation, and 1 had recurrence due to extensive drug resistance (XDR).


CONCLUSIONS
Standardized antituberculous therapy is fundamental for preventing the recurrence of tuberculosis, and individualized antituberculous therapy adjustment according to the results of bacterial culture and drug sensitivity tests can be the most effective means for preventing drug resistance and reducing tuberculosis recurrence.
Fu
Zhong-Quan
ZQ
Department of Spine Surgery, Third Affiliated Hospital of Southern Medical University, Guangzhou, China. spine_fzq1978@126.com
Zhang
Zhong-Min
ZM
Jin
Da-Di
DD
Chen
Jian-Ting
JT
Qu
Dong-Bin
DB
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods; D010994:Pleura / Q000293:injuries; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000601:surgery*; D014399:Tuberculosis, Spinal / Q000601:surgery*; D055815:Young Adult