title: The role of surgical timing in the treatment of thoracic and lumbar spinal tuberculosis.
abstract: OBJECTIVE
  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: Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China.
authors: Peng
authors: P
authors: Zhang
authors: Yong
authors: Y
authors: Shen
authors: Wen-Yuan
authors: WY
authors: Ding
authors: Wei
authors: W
authors: Zhang
authors: Zikun
authors: Z
authors: Shang
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001799:Blood Sedimentation; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents