Frequently asked questions about spinal tuberculosis: What should I look for in postoperative rehabilitation?

  1.When can I start standing and walking training after surgery?  Rehabilitation training should be started immediately after surgery for spinal tuberculosis, and there are some controversies and differences at home and abroad regarding the time point for standing and walking training. Foreign scholars tend to advocate early ambulation, with braces being worn on the ground within 3 days after surgery. Domestic scholars hold a relatively conservative view, requiring patients to rest in bed for at least 2 weeks before starting to try to walk on the ground. In fact, in this regard, we also advocate individualization: that is, the time to stand and walk should be decided according to the site and extent of spinal damage, the mode and degree of surgical fixation, and the patient’s own bone quality and physical condition. Generally speaking, if the condition allows, early activity is beneficial to the early recovery of limb function.  2.How long do I need to wear a brace after surgery?  One of the principles of spinal tuberculosis treatment is braking. Traditional braking methods include bed rest, plaster immobilization, brace immobilization and traction. In general, the surgery can be performed with internal fixation of the instrument to obtain immediate stability of the spine, but in order to ensure the braking effect, the brace should be worn for about 3 months after surgery. If the doctor confirms that bony fusion has been achieved in the focal area, the brace can be considered for removal at the follow-up examination by X-ray or CT.  3.What are the precautions for exercise in patients with spinal tuberculosis?  The general principle: under the guidance of the doctor, exercise according to your ability and in a gradual manner. Different parts of the body and different surgical methods should be used. The basic steps are as follows: joint exercises and muscle strength exercises for the limbs in bed as early as possible after surgery to prevent muscle atrophy and joint stiffness; early after surgery, walk on the floor with the support of family members under the protection of a lumbar brace, neck brace or brace, walk with crutches, and gradually develop to walking alone and for a long time, and then practice squatting, even swimming and jogging. Specific exercise, frequency and intensity, should follow the doctor’s orders.  4.What should I pay attention to in terms of diet for patients with spinal tuberculosis?  Patients with spinal tuberculosis should be supplemented with high-calorie, high-protein foods, and should also pay attention to the interaction between anti-tuberculosis drugs and food to avoid adverse reactions such as food poisoning and allergies. For example, isoniazid can cause a deficiency of monoamine oxidase in the body, which in turn reduces the ability to oxidize amines. Therefore, foods with high histamine content, such as fish without scales and sea fish left for a long time, should be avoided during anti-TB drug treatment. Isoniazid should also not be taken at the same time as wines with high tyrosine content. Lactose hinders the absorption of isoniazid drugs and should not be taken at the same time. Milk causes slow absorption of rifampicin and should also be reduced or avoided at the same time.