title: [Surgical treatment of drug-resistant spinal tuberculosis].
abstract: OBJECTIVE
  To study the curative effect of surgical treatment of drug-resistant spinal tuberculosis.
  
  
  METHODS
  From March 2005 and April 2009, the clinical data of 60 patients with drug-resistant spinal tuberculosis were retrospectively analyzed. Including 36 males and 24 females; aged from 5 to 79 years with an average of 47.3 years. Thirty-four patients had neurological deficits, among them, 2 cases were grade A, 5 cases were grade B, 13 cases were grade C, 14 cases were grade D according to ASIA standard. According to the severity and location of the infection, the patients underwent anterior, posterolateral costotransversectomy or posterior debridement and bone grafting and internal fixation. The antituberculous chemotherapy for a total of 12 to 18 months was guided by conventional and genotypic drug susceptibility testing. Tubercular relapse, neurological function, spinal fusion were observed by ASIA grade, X-ray and CT scan.
  
  
  RESULTS
  All cases were followed up from 1 to 5 years with an average of 3.1 years. Recurrence was found in 2 cases who were cured after second operation. 34 cases with neurological deficits recovered totally or partially. X-ray or CT films showed spinal fusion in 57 patients.
  
  
  CONCLUSIONS
  The therapeutic effect of individuall operative options is good in treating drug-resistant spinal tuberculosis after antituberculous chemotherapy based on conventional and genotypic drug susceptibility testing.
authors.affiliation: Department of Orthopaedics, 309th Hospital of PLA, Beijing 100091, China.
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Li
authors.forename: Yuan-Zheng
authors.initials: YZ
authors.lastname: Ma
authors.forename: Ying
authors.initials: Y
authors.lastname: Hou
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Xue
authors.forename: Feng-Shan
authors.initials: FS
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000187:drug effects / Q000235:genetics; D011859:Radiography; D012189:Retrospective Studies; D013131:Spine; D018088:Tuberculosis, Multidrug-Resistant / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents