PURPOSE: To determine the outcome and safety of surgical treatment of thoracic and lumbar spinal tuberculosis in patients without obvious clinical and laboratory improvement after preoperative short-time chemotherapy. METHODS: Data of 86 patients with single-level thoracic and lumbar tuberculosis, treated by one-stage posterior instrumentation combined with anterior radical debridement and fusion, were studied retrospectively. Patients were divided into two groups based on the results of erythrocyte sedimentation rate (ESR) after preoperative 2-week chemotherapy. Surgical outcome and prognosis were compared between the two groups. RESULTS: After antituberculous chemotherapy for 2 weeks, the ESR did not decrease or even increase in 57 patients (group A), but decreased in 29 patients (group B). However, the ESR decreased gradually after surgery and returned to a normal level at the final follow-up in both groups. Between group A and B, no significant difference was observed in pain improvement (6.3 ± 1.4, 6.4 ± 1.4, respectively, P = 0.805). The corrected angle was 12.4° ± 5.9°, 13.8° ± 6.4°, respectively, for group A and group B (P = 0.305). CONCLUSIONS: It is safe and effective to carry out the surgery just after a short-time antituberculous chemotherapy. And it is the postoperative drugs, not the preoperative drugs, that play an important role in reinforcing the surgical outcome.
PURPOSE: To determine the outcome and safety of surgical treatment of thoracic and lumbar spinal tuberculosis in patients without obvious clinical and laboratory improvement after preoperative short-time chemotherapy. METHODS: Data of 86 patients with single-level thoracic and lumbar tuberculosis, treated by one-stage posterior instrumentation combined with anterior radical debridement and fusion, were studied retrospectively. Patients were divided into two groups based on the results of erythrocyte sedimentation rate (ESR) after preoperative 2-week chemotherapy. Surgical outcome and prognosis were compared between the two groups. RESULTS: After antituberculous chemotherapy for 2 weeks, the ESR did not decrease or even increase in 57 patients (group A), but decreased in 29 patients (group B). However, the ESR decreased gradually after surgery and returned to a normal level at the final follow-up in both groups. Between group A and B, no significant difference was observed in pain improvement (6.3 ± 1.4, 6.4 ± 1.4, respectively, P = 0.805). The corrected angle was 12.4° ± 5.9°, 13.8° ± 6.4°, respectively, for group A and group B (P = 0.305). CONCLUSIONS: It is safe and effective to carry out the surgery just after a short-time antituberculous chemotherapy. And it is the postoperative drugs, not the preoperative drugs, that play an important role in reinforcing the surgical outcome.
Authors: Laxmaiah Manchikanti; Vidyasagar Pampati; Satya P Sanapati; Mahendra R Sanapati; Alan D Kaye; Joshua A Hirsch Journal: Curr Pain Headache Rep Date: 2020-01-30