术后复发性胸腰椎结核的病例特点及临床意义

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Abstract Objective To provide guidance for early clinical discovery，early treatment and improvement of the prognosis of patients with recurrent thoracolumbar tuberculosis.Methods A retrospective analysis was made of 69 patients with recurrent thoracolumbar tuberculosis admitted to our hospital from January 2006 to 2015，including 40 males and 29 females aged(37.5±14.5)years，13 cases of thoracic tuberculosis，20 cases of thoracolumbar tuberculosis and 32 cases of lumbar tuberculosis.4 cases of lumbosacral tuberculosis，a statistical analysis of their clinical manifestations，imaging features and laboratory examinations.Results Pain which is the major clinical manifestations was found in 55.1% of the recurrent patients.89.9% patients developed paravertebral abscess，which is the most common imaging manifestation.Tuberculosis bacteria culture and drug sensitivity test was performed in 53 patients.A total of 22 patients developed drug resistance.Drug resistant tuberculosis accounted for 41.5%.28 patients with pulmonary tuberculosis，2 patients with pulmonary tuberculosis associated with urinary system tuberculosis and 1 patient with tuberculous peritonitis.Before the recurrence，32 cases had 6 months，9 cases had 6 to 12 months，8 cases had 12 to 18 months，4 cases had 18 to 24 month，3 cases had 24 to 36 months，5 cases 36 to 48 months，3 cases had 48 to 60 months，5 cases had 60 months or more，the longest time was 84 months(7 years).43 patients had only one recurrence，and 26 patients recurred repeatedly.The recurrence rate was 37.7% in the recurrent patients.Conclusion 2 years after surgery is the most concentrated time for recurrence in Surgical treatment of thoracolumbar tuberculosis.If pain，sinus tract，local mass and nerve symptoms，ESR and C-reactive protein were higher than normal 3 month after operation，the possibility of recurrence after operation should be warned.If we find paravertebral abscess，internal fixation loosening，bone destruction and so on，it is very important to improve the prognosis of patients by taking treatment measures as early as possible.

Key words： spinal tuberculosis thoracolumbar tuberculosis recurrent tuberculosis case characteristics

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