Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation

Wang, Zili; Shi, Jiandang; Geng, Guangqi; Qiu, Hongyan

doi:10.1007/s00586-012-2536-0

Cited by 30 publications

(48 citation statements)

References 21 publications

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“…Waist flexion, overextension, lateral bending, and rotation were avoided before bone graft fusion. A 2HRZS/2-xHRZ regimen was used for chemotherapy; the duration of intensive chemotherapy was 2 months and that of consolidation chemotherapy was 2–7 months [ 10 , 11 ]. Both the patient’s follow-up and chemotherapy management were performed by a specifically assigned doctor.…”

Section: Methodsmentioning

confidence: 99%

Five-year outcomes of posterior affected-vertebrae fixation in lumbar tuberculosis patients

et al. 2018

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BackgroundPosterior instrumentation after deformity correction is an important method for reconstruction of spinal stability in the management of lumbar tuberculosis (TB). However, the commonly used methods include both long- and short-segment fixation of normal motor units. There has been no report regarding affected-vertebrae fixation of lumbar TB.MethodsData from 135 patients with lumbar TB who underwent posterior instrumentation and either affected-vertebrae fixation or short-segment fixation using a combined posterior and anterior approach were retrospectively reviewed. Among these patients, 71 cases were treated with affected-vertebrae fixation, and 64 cases were treated with short-segment fixation. Debridement, bone grafting, deformity correction, and decompression were performed within all affected segments. Operative times, intra-operative blood loss, TB cure rates, bone graft fusion rates, degree of deformity correction, neurological function, pain recovery, and complications were analyzed.ResultsComparing affected-vertebrae fixation vs. short-segment fixation groups, respectively, the number of the affected segments was 107 vs. 98; average number of affected segments was 1.51 vs. 1.53; total number of fixed segments was 107 vs. 226; average number of fixed segments was 1.51 vs. 3.53; average blood loss was 726.2 ml vs. 948.5 ml; average operative time was 210.4 min vs. 270.3 min; and average hospitalization costs were 29,000 RMB vs. 42,000 RMB (all p values < 0.05). In the affected-vertebrae fixation vs. short-segment fixation groups, respectively, TB cure rates were 82.61% vs. 84.62% at 6 months after operation and 97.83% vs. 97.44% at 5 years after operation; bone fusion rates were 86.96% vs. 87.18% at 6 months after operation and 97.83% vs. 97.66% at 5 years after operation; average number of degrees of Cobb’s angle correction were 13.1° vs. 13.7°; average correction losses were 1.9° vs. 1.4°; and complication rates were 12.04% vs. 12.97% (all p values > 0.05).ConclusionUnder strict surgical indications, posterior instrumentation on affected-vertebrae is a safe, effective, and feasible fixation method in the treatment of lumber TB.

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Section: Methodsmentioning

confidence: 99%

Five-year outcomes of posterior affected-vertebrae fixation in lumbar tuberculosis patients

et al. 2018

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“…With the aid of discs' elastic function, lumbar can effectively buffer shock transmitted from the lower limbs, which prevents neural tissue injury in the spinal canal from sudden trauma. Inconspicuous manifestations can delay the diagnosis of lower lumbar TB; therefore, an effective surgery can shorten the duration of anti-TB drug treatment, fasten the patients' rehabilitation and reduce the occurrence of anti-TB drug resistance [5].…”

Section: Discussionmentioning

confidence: 99%

Comparative study of a single posterior approach and combined posterior-anterior approach for patients with lower lumbar tuberculosis

Cui¹,

Gong²,

Zhou³

et al. 2020

Preprint

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Background To compare the surgical effect of a single posterior approach with a combined posterior-anterior approach for patients with lower lumbar tuberculosis (TB). Method: 119 cases of lower lumbar TB were conducted from January 2008 to December 2016 using two procedures. Out of 119 cases, 73 patients were operated with a single posterior approach (group A), whereas, 46 patients were operated using the combined posterior-anterior approach (group B). The evaluative items were compared between two groups, including operation time, blood loss, surgical complication rate, cure rate, Visual Analog Scale (VAS) score, Japanese Orthopaedic Association (JOA) score, kyphosis Cobb’s angle, and time of abscess disappearance. Furthermore, the period between bone graft fusion and the patients’ return to regular activity were compared between the two groups to evaluate the therapeutic effects. Results No significant differences of gender, age, BMI, illness duration, and preoperative indexes of VAS, JOA, ESR, CRP, and kyphosis Cobb’s angle were found between the two groups of patients, who were followed-up for 24–60 months. Although the operation time and blood loss rate were less in group A as compared to group B, no remarkable differences in VAS, JOA, ESR, CRP and kyphosis Cobb’s angle were found. Furthermore, the rate of surgical complications, cure rate, and time of bone graft fusion did not show appreciable differences between the two groups. However, the time of abscess disappearance and time return to regular activity were less in group B as opposed to patients of group A. Conclusion Both single posterior approach and combined posterior-anterior approach are effective for the treatment of lower lumbar TB with a high cure rate and low surgical complication rate. Addtionally, single posterior approach is less traumatic than the combined posterior-anterior approach, but with a much slower lesion healing and activity recovery.

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“…There are variations in practice with regards to spinal tuberculosis treatments. Some centers give medical treatment until a neurological deficit appears [ 2 , 3 , 9 , 10 ]. Another method is surgery with medical treatment.…”

Section: Discussionmentioning

confidence: 99%

Spinal Tuberculosis Mimicking Failed Back Surgery

Özdoğan¹,

Yaltırık

Düzkalır

et al. 2018

Am J Case Rep

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Patient: Female, 59Final Diagnosis: Spinal tuberculosisSymptoms: Back pain • tiredness • night sweatsMedication: —Clinical Procedure: Surgery and medical treatmentSpecialty: NeurosurgeryObjective:Challenging differential diagnosisBackground:The aim of this study was to draw attention to rare spinal infections in recurrent failed spinal surgeries.Case Report:A 59-year-old female was admitted to the hospital for back pain, which was assessed as a 9 on the visual analogue scale (VAS); the patient reported tiredness and night sweats. She had an operation for L3–4 far lateral disc herniation four years ago. Then another operation for L4–5 disc herniation six months ago and immediately three months later she has an operation with L3–4–5 fixation again. She had hypothyroidism, diabetes mellitus, and hypertension. Her daughter was cured of pulmonary tuberculosis 20 years ago. We performed an operation by L4–5 discectomy; all granulation formation with inflammatory processes were debrided and irrigated with antibiotics at levels of L3–5. The old fixation was controlled and replaced. Her back pain improved immediately after surgery; she had a score of 2 on the VAS. Two days after her surgery, our Infection Disease Department reported acid resistant bacillus (ARB+) in samples and began anti-tuberculosis medication.Conclusions:Spinal infections should always be taken into consideration in recurrent failed back surgeries.

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Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation

Cited by 30 publications

References 21 publications

Five-year outcomes of posterior affected-vertebrae fixation in lumbar tuberculosis patients

Five-year outcomes of posterior affected-vertebrae fixation in lumbar tuberculosis patients

Comparative study of a single posterior approach and combined posterior-anterior approach for patients with lower lumbar tuberculosis

Spinal Tuberculosis Mimicking Failed Back Surgery

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