Efficacy of single-stage posterior surgery for HIV-positive patients with thoracolumbar tuberculosis

Yao Zhang; Chang-Song Zhao; Jia-Min Chen; Qiang Zhang

doi:10.1186/s12981-022-00478-9

Efficacy of single-stage posterior surgery for HIV-positive patients with thoracolumbar tuberculosis

AIDS Res Ther. 2022 Nov 22;19(1):53. doi: 10.1186/s12981-022-00478-9.

Authors

Yao Zhang¹, Chang-Song Zhao¹, Jia-Min Chen², Qiang Zhang³

Affiliations

¹ Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015, China.
² Department of Pathology, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015, China.
³ Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun East Street, Chaoyang District, Beijing, 100015, China. 765926411@qq.com.

Abstract

Objective: We aimed to observe the clinical effect of single-stage posterior surgery on HIV-positive patients with thoracolumbar tuberculosis.

Methods: From October 2015 to October 2019, 13 HIV-positive patients with thoracolumbar tuberculosis who underwent single-stage posterior surgery were retrospectively analyzed (observation group), and 13 HIV-negative patients with thoracolumbar tuberculosis who were matched with the gender, age, operative site, and surgical approach during the same period were selected as the control group. Postoperative complications, hemoglobin, albumin, CD4⁺T lymphocyte count, operative site, operative time, and blood loss were recorded between the two groups. The clinical efficacy was evaluated by the visual analog scale (VAS), American Spinal Injury Association (ASIA) scale, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), kyphotic angle, correction rate of kyphosis, angle loss, and bone graft fusion time.

Results: In the observation group, 7 patients had postoperative complications, including 1 patient with cerebrospinal fluid leakage, 1 patient with nerve root irritation, 1 patient with an opportunistic infection, and 4 with delayed wound healing. In the control group, 2 patients developed postoperative complications, including 1 with nerve root irritation and 1 with delayed wound healing. There was no statistically significant difference in the incidence of postoperative complications between the two groups (P > 0.05). CD4⁺T lymphocyte count, hemoglobin, and albumin in HIV-positive patients with postoperative complications were statistically different from those without postoperative complications (P all < 0.05). No tuberculosis recurrence was found at the last follow-up, ESR and CRP returned to normal, and there were no statistically significant differences in bone graft fusion time, VAS score, ASIA scale, correction rate of kyphosis, and angle loss between two groups (P all > 0.05).

Conclusion: Single-stage posterior surgery for HIV-positive patients with thoracolumbar tuberculosis could achieve satisfactory clinical efficacy through comprehensive preoperative evaluation, standardized perioperative antiviral and anti-tuberculosis treatments, and prevention of postoperative complications.

Keywords: HIV; Posterior surgery; Spinal tuberculosis; Thoracolumbar vertebrae.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Albumins
C-Reactive Protein
HIV Infections*
HIV Seropositivity*
Humans
Kyphosis*
Postoperative Complications
Retrospective Studies
Tuberculosis*

Substances

C-Reactive Protein
Albumins