[Surgical treatment of drug-resistant spinal tuberculosis].
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.
Li
Da-Wei
DW
Department of Orthopaedics, 309th Hospital of PLA, Beijing 100091, China.
Ma
Yuan-Zheng
YZ
Hou
Ying
Y
Xue
Hai-Bin
HB
Huang
Feng-Shan
FS
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
D000995:Antitubercular Agents