Decide whether to operate according to the indication of operation. Even those with surgical indications need 2-4 weeks of non-surgical treatment as preoperative preparation. Non-surgical treatment includes systemic anti-tuberculosis drug therapy and local immobilization. Generally, two anti-tuberculosis drugs are used in combination, and then treated with a single anti-tuberculosis drug after 3 ~ 6 months. The whole course of treatment should be no less than 2 years. The local brake is fixed with plaster vest (thoracic and upper lumbar tuberculosis), and one thigh (lower lumbar tuberculosis) is fixed with plaster belt. The fixed period is 3 months, and more bed rest is needed during the fixed period. Those who can't stand the whole body plaster fixation can sleep in a special plaster bed for 3 months.

2. Surgical therapy

(1) Incision and drainage of cold abscess lead to secondary infection in patients with obvious symptoms of systemic poisoning. Incision and drainage can save lives when patients can't tolerate lesion resection. After the incision of cold abscess, the symptoms of systemic poisoning are expected to be controlled, but the incision is extremely difficult to heal. Because the abscess is extremely deep, most of them are cut at the top of the abscess, and the drainage is not smooth. 4% isoniazid solution can be used to flush the pus cavity every day and keep the sinus open. A thick rubber tube can be inserted to dilate the ostium of the sinus, or double cannula drainage can be used. Be careful not to let foreign bodies such as rubber tubes and cotton balls fall into the abscess cavity. Cold abscess without secondary infection is not suitable for incision and drainage. Because of the extensive scar tissue around sinus, inflammatory infiltration and unclear anatomical structure, it is not advisable to perform fistula resection rashly to avoid damaging adjacent blood vessels, nerves or important organs. Nor does it advocate layered puncture and drainage of cold abscess and injection of anti-tuberculosis drugs.

(2) Focal debridement Since the forties and fifties of last century, the successful synthesis and extraction of anti-tuberculosis drugs have provided conditions for the implementation of focal debridement. There are two kinds of operations: anterior and posterior. Posterior surgery is usually used for thoracic tuberculosis. Cervical tuberculosis was mostly removed from the front and fixed with plaster for 3 ~ 4 months after operation. After the review, remove or fix the gypsum as appropriate.

(3) Posterior spinal fusion combined with posterior pedicle screw system and anterior debridement can strengthen the stability of the spine, make the patient get out of bed early, and fix the plaster vest 3 ~ 6 months after operation.

(4) Bone grafting and anterior internal fixation should be carried out at the same time when the focus of anterior spinal fusion is cleared, so as to stabilize the spine and facilitate bone grafting and fusion.

(5) Orthopedic surgery is mainly to correct kyphosis.

Exercise: lie in a hard bed before recovery.

Prone swallow. On a hard bed or clean hard floor, take a prone position, face down, lift your arm with the shoulder joint as the support point, gently lift your head while your arm is up, and lift your shoulders back and up. At the same time, gently lift your feet, contract the muscles at the bottom of your waist, try to support your body with your ribs and abdomen for 3-5 seconds, then relax your muscles and rest your limbs and head for 3-5 seconds.

You can do it 30-50 times a day. Can be divided into 2-3 times, adhere to more than 6 months. It is best for patients after lumbar surgery to have a lifelong exercise program.

You can do 10-20 times at first, and gradually increase it. Do it in bed before going to bed, but stick to it.