Operative Therapy Practices in Tubercular Patients with Bone and Joint Effects of Different Etiologies

Introduction. A decrease in the number of patients with tuberculosis of the bone system coincides with an increase in the number of indications and methods for operational treatment. The continuing development in skeletal tuberculosis surgery techniques determines the search for a material capable of replacing autologous bone. Therefore, the main purpose of this paper is to enhance the results of treatment of spinal caries to speed up treatment of tuberculous osteomyelitis by applying collagen material and to solve the issues of orthopedic alignment for TB patients.

Materials and methods. Surgical treatment was carried out on 32 patients in 2016–2018. The patients were divided into several groups: 18 underwent transpedicular fixation of the spine, 2 had concomitant HIV-infection, 2 underwent necrectomy of vertebral bodies with anterior spondylodesis lift system, 1 underwent necrectomy of vertebral bodies with bone autoplasty and with plate fixation, 2 had cervical spine fixation, while 2 patients with pulmonary tuberculosis in the humerus traumatic fracture received intramedullary surgery.

Results. 31 patients reported a positive dynamic following surgery, while a fatal outcome not connected with the surgery was experienced in one case. Complications included allergic reaction in one case, while three patients developed postoperative wound seroma (both patients having HIV infection). One patient reported pain in the lower extremities following TPF. 3 patients with osteitis underwent necrectomy and filling of cavities with collagen material. Wounds were healed by secondary healing, while no rejection of collagen material took place.

Conclusions. Introduction of collagen material in osteitis treatment can speed up fistula healing. The research work demonstrated the possibility of providing trauma care to patients under the conditions of an antitubercular centre.

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