Abstract: ［Abstract］ Objective〖HTSS〗To investigate the treatments and solutions of perioperative management of spinal tuberculosis.
〖HTH〗〖WTHZ〗Methods〖HTSS〗A retrospective analysis was conducted on spinal tuberculosis patients during perioperative period. The clinical information from 402 patients with spinal tuberculosis was analyzed. Among those patients, 220 cases were male and 182 cases were female, the average age was (47.8±26.6) years old (range one year and six months to eighty-nine years). The lesion located at cervical spine in 10 cases, chest spine in 6 cases, thoracic spine in 152 cases, Thoracolumbar spine in 19 cases, lumbar spine in 170 cases, lumbosacral spine in 45 cases, combined paraplegia in 18 cases. This article summarized treatments, precautions, complications and their corresponding treatment methods, effects of spinal tuberculosis patients during perioperative period.
〖HTH〗〖WTHZ〗Results〖HTSS〗Among the 402 patients, the pathological diagnosis rate was 77.11%. The preoperative antituberculosis time was 28 cases in 3-7 days, 280 cases in 7-21 days, 59 cases in 21-90 days, and 35 cases in 90 days.The top 4 associated systemic diseases were pulmonary tuberculosis，hypoproteinemia，hypertension，and diabetes. The positive rate of tuberculosis was 48.51%, and the drug-resistant tuberculosis accounted for 20.40%. Multidrug-resistant tuberculosis accounted for 43.90%. The anti-tuberculosis program used before surgery were the initial treatment plan, the re-treatment plan, and the drug resistance program.The surgical methods included 16 cases of anterior approach for cervical and cervical thoracic segments, 326 cases of thoracolumbar anterior approach, 15 cases of posterior anterior approach, 28 cases of lumbosacral anterior approach, 5 cases of posterior approach, and 12 cases of posterior anterior approach. 384 cases achieved bone lesions healing standards within a year, the healing rate was 95.52%. Bone lesions of 8 cases did not heal, the rate of failure was 1.99%. Five cases were taken secondary surgery and the secondary operation rate was 1.24%. The bone lesions of 2 cases relapsed 1 year later, and the recurrence rate was 0.50%. During perioperative period, there were death in 2 cases, thoracic hemorrhage after thoracotomy in 2 cases, intercostal neuralgia in 18 cases.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Perioperative management is an important guarantee for a successful operation. Accurate diagnosis and identification before surgery, and standardized anti-tuberculosis treatment are the basis for the treatment of spinal tuberculosis. Etiological examination and bacterial sensitivity test performed during perioperative period shall be conducive to the control of recurrence, improve the cure rate. Timely and correctly handle other associated diseases, and rationally develop individualized surgical methods according to the condition are the guarantee of treatment success.

Key words: tuberculosis,spinal, perioperative period, lesion removal