Abstract
Objective
To investigate the clinical characteristics and identify risk factors of postoperative recurrence in thoracolumbar tuberculosis, aiming to assess clinical significance and propose management strategies.
Methods
Retrospective review of 69 patients' medical records with postoperative recurrence of thoracolumbar tuberculosis from 2006 to 2019, including demographics, clinical presentations, radiographic data, drug susceptibility, laboratory results, and recurrence patterns.
Results
The study included 40 males and 29 females, with a mean age of 36.1 ± 14.2 years at initial surgery and 37.5 ± 14.5 years at recurrence. Manifestations included pain (55.1%), sinus tracts (47.8%), and neurological deficits (37.7%). Radiographic assessments showed paravertebral (89.9%) and flowing abscesses (37.7%). Drug resistance was present in 41.5% of cases. Inflammatory markers were elevated in most patients, with anemia and hypoalbuminemia frequently observed. Most recurrences occurred within 24 months post-surgery, with a maximum interval of 84 months, and 37.7% had multiple recurrences.
Conclusion
Postoperative recurrence in thoracolumbar tuberculosis is multifactorial, linked to drug-resistant tuberculosis, inconsistent medication adherence, poor nutrition, inadequate immobilization, and systemic tuberculosis infections. Optimal postoperative surveillance and clinical management necessitate a focus on inflammatory markers, advanced imaging, diligent patient education, and rigorous follow-up to diminish recurrence rates and enhance patient outcomes.