[Misdiagnosis and mismanagement of pathological fractures in spinal tuberculosis:causes and management strategies].

OBJECTIVE: To explore the perioperative management of pathological fractures in spinal tuberculosis patients undergoing vertebral augmentation,and to provide clinical data for the differential diagnosis of spinal tuberculosis. METHODS: A retrospective analysis was conducted on the clinical data of 30 spinal tuberculosis patients who underwent vertebral augmentation from April 2017 to May 2022. According to the treatment methods,the patients were divided into three groups:Group A (posterior spinal approach with bone cement mass removal,decompression,and bone graft fusion),Group B(posterior spinal decompression and bone graft fusion),and Group C (conservative treatment). Group A included 10 patients(6 males and 4 females) with an average age of (68.50±6.81) years. Group B included 12 patients (8 males and 4 females) with an average age of (67.92±5.86) years. Group C included 8 patients (4 males and 4 females) with an average age of (65.00±7.09) years. All patients received anti-tuberculosis drug treatment for 18 to 24 months. The erythrocyte sedimentation rate (ESR),C-reactive protein (CRP),tuberculosis infection T-cell spot test (T-SPOT.TB),visual analogue scale (VAS) for pain,American Spinal Injury Association(ASIA) neurological function classification,and modified Barthel index(MBI) for assessing activities of daily living were observed and compared among the three groups. RESULTS: