The effectiveness of simultaneous surgical treatment of tuberculosis of the respiratory system and thoracic spine with treatment of the implant bed with a laser with a wavelength of 970 nm

Introduction. Tuberculosis of the musculoskeletal system occupies the fourth place in the incidence structure among extrapulmonary lesions caused by M. tuberculosis, accounting for about 10% among all localizations. In some cases, tuberculosis of the musculoskeletal system is combined with tuberculosis of the lungs.
The aim: to evaluate the effectiveness of simultaneous surgical treatment in patients with tuberculosis of multiple localization: tuberculosis of the respiratory system and thoracic spine, using titanium implants in combination with bone autoplasty and a high-energy laser.
Materials and methods. The analysis of the results of simultaneous surgical treatment of the lungs and thoracic spine performed in 54 patients with tuberculosis of multiple localizations: tuberculosis of the lungs and thoracic spine in the period from 2017 to 2024. All patients were divided into 2 groups: group 1, recruited from 2021 to 2024, consisted of 24 patients who underwent intraoperative irradiation of the bed of the affected vertebrae with a high–energy laser, group 2, recruited from 2017 to 2020, consisted of 30 patients who underwent surgery without the use of a high–energy laser. The groups were comparable to each other (p>0.05).
Results. The median duration of surgery in group 1 was 277.5 (62.5; 359.5 minutes) minutes, in group 2 – 272.5 (61.25; 436) minutes (p>0.05). The median volume of blood loss in group 1 was 550 (33.6; 1165) ml, in group 2 – 387.5 (50; 2443.25) ml (p>0.05). The median stay in the intensive care unit (ICU) in group 1 was 4 (3; 7) days; in group 2 4.5 (3; 7.85) days (p>0.05). The analysis of early postoperative complications revealed that in group 1, complications were significantly less common – 12.6% of cases than in group 2 – in 40% of cases (p<0.05).
Conclusion. These results were achieved primarily by reducing the frequency of intrapleural hemorrhagic complications (bleeding, prolonged exudative pleurisy), the source of which in the control group was the spongy bone tissue of the removed parts of the thoracic vertebrae.

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