Tuberculous lymphadenopathy without HIV infection, in comparison with those with HIV infection, was characterized by a more favorable clinical course, limited lesion and, especially important, limited caseous-necrotic changes. Analysis of the histological picture of the removed lymph nodes in patients with HIV-i made it possible to distinguish three activities of tuberculous lymphadenopathy: an inactive phase (with a predominance of a productive cellular reaction) - in 3 patients (5.3%), an active (with a predominantly productive-necrotic tissue reaction) - in 11 patients (19.3%), the phase of progression of the pathological process (mainly necrotic lesions, suppuration and formation of fistulas) - in 43 patients (75.4%). It was found that the inactive phase is 5.5 times more common in patients without HIV than in patients with HIV (29.3% and 5.3%, respectively, P˂0.001), while the active phase and the progression phase was 1.5 and 1.3 times more frequent in patients with HIV than in patients without HIV (19.3% and 13.1, respectively, P˃0.5; 75.4% and 57, 6%, respectively, P˂0.02).
The study is based on data from a survey of 658 patients with osteoarticular tuberculosis, which was performed in 482 (73.3%) cases of radical reconstructive surgery (RVO) of the spine. Of 482 patients with spinal tuberculosis, in 461 (95.6%) cases, RVO was using a titanium mesh cage (Piramesh), and in 21 (4.4%) patients using the traditional-classical method with autobone fusion.
To fill the lumen of the titanium mesh cage, it is rational to use autologous crumbs, collapAn and hydroxyapatite compounds. In case of tuberculosis of large joints, to restore the function and defect of bones, total joint arthroplasty is a solution to a serious problem.