Analysis of risk factors for internal fixation failure after thoracolumbar tuberculosis lesion removal and bone graft fusion with internal fixation
Objective To analyze the risk factors of internal fixation failure after thoracolumbar tuberculosis lesion removal and bone graft fusion with internal fixation,and to provide theoretical basis for prevention of thoracolumbar tuber-culosis surgical failure.Methods A total of 446 patients with thoracolumbar tuberculosis were treated with lesion remov-al and bone graft fusion with internal fixation surgery and were followed up for more than 2 years,during which 48 cases of failure of internal fixation were found.The basic data,surgical data and postoperative follow-up data of all patients were collected.A univariate Logistic regression analysis model was established with internal fixation failure after thoracolumbar tuberculosis lesion removal and bone graft fusion with internal fixation as the dependent variable.Independent variables in-cluded gender,age,preoperative complications,lesion scope,surgical mode selection,preoperative and postoperative for-mal chemotherapy,strict immobilization at surgical site,combined with extraspinal tuberculosis,combined with preopera-tive kyphosis,preoperative and postoperative complications,and postoperative tuberculosis drug resistance.Univariate Lo-gistic regression analysis was performed by stepwise screening method.The indicators with statistically significant differ-ence in univariate analysis were incorporated into the multivariate Logistic regression analysis model as independent vari-ables,and the internal fixation failure after thoracolumbar tuberculosis lesion removal and bone graft fusion with internal fixation was taken as dependent variable.The risk factors for internal fixation failure after thoracolumbar tuberculosis le-sion removal and bone graft fusion with internal fixation were analyzed by multivariate Logistic regression analysis.Re-sults The results of univariate Logistic regression analysis showed that lesion scope,surgical mode selection,preopera-tive and postoperative formal chemotherapy,strict immobilization at surgical site,combined with preoperative kyphosis,and postoperative tuberculosis drug resistance were the relevant factors for the internal fixation failure after thoracolumbar tuberculosis lesion removal and bone graft fusion with internal fixation(all P<0.05).The results of multivariate Logistic regression analysis showed that the lesion scope(multiple vertebrae),surgical method(anterior),irregular preoperative and postoperative chemotherapy,non-strict immobilization at surgical site,combined with preoperative kyphosis,and post-operative tuberculosis drug resistance were independent risk factors for internal fixation failure after thoracolumbar tubercu-losis lesion removal and bone graft fusion with internal fixation(all P<0.05).Conclusion Thoracolumbar tuberculosis lesion removal and bone graft fusion with internal fixation surgery has a high risk of internal fixation failure.The lesion scope(multiple vertebrae),surgical method(anterior),irregular preoperative and postoperative chemotherapy,non-strict immobilization at surgical site,combined with preoperative kyphosis,and postoperative tuberculosis drug resistance are in-dependent risk factors for internal fixation failure after thoracolumbar tuberculosis lesion removal and bone graft fusion with internal fixation.
tuberculosisspine tuberculosisthoracolumbar tuberculosisinternal fixationlesion removal and bone graft fusion with internal fixation
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