title: The efficacy of local continuous chemotherapy and postural drainage in combination with one-stage posterior surgery for the treatment of lumbar spinal tuberculosis.
abstract: BACKGROUND
  The objective of this study was to compare the outcomes of one-stage posterior surgery involving debridement, bone grafting, and instrumentation with and without local continuous chemotherapy and postural drainage for the treatment of lumbar spinal tuberculosis.
  
  
  METHODS
  From January 2009 to January 2013, 109 patients with lumbar spinal tuberculosis were treated in our center using a posterior surgical approach. Patients underwent one-stage posterior debridement, bone grafting, and instrumentation, without (group A) and with (group B) local continuous chemotherapy and postural drainage. Clinical and radiographic results for the two groups were analyzed and compared. Clinical efficacy was evaluated based on surgery duration and blood loss. The Frankel scale was used to evaluate neurological function. A visual analog scale was used to assess low back pain. Bone graft fusion and instrumentation failure were monitored by radiography, and tuberculosis activity was monitored by erythrocyte sedimentation rate (ESR) and C-reactive protein testing.
  
  
  RESULTS
  Groups A and B contained 52 and 57 patients, respectively. Patients were followed for 18-36 (mean, 26.64 ± 4.2) months. All bone grafts ultimately fused, but the fusion rate was significantly more rapid in group B [6.4 ± 0.5 (range, 5-10) months] than in group A [8.9 ± 0.6 (range, 6-12) months; P < 0.05]. At 6 weeks postoperatively, ESR levels differed significantly between groups A and B (24.6 ± 1.5 vs. 16.3 ± 1.1 mm/h; P < 0.05). ESR levels normalized in both groups at 16 weeks.
  
  
  CONCLUSIONS
  Local continuous chemotherapy and postural drainage effectively eliminated infection foci caused by abscess remnants and accelerated interbody bone fusion in patients with lumbar spinal tuberculosis undergoing one-stage posterior surgery involving debridement, bone grafting, and instrumentation.
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. zzz350815@163.com.
authors: Yongchun
authors: Y
authors: Zhou
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. 908569647@qq.com.
authors: Zongrang
authors: Z
authors: Song
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. 27426621@qq.com.
authors: Jing
authors: J
authors: Luo
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. zyc350815@163.com.
authors: Jijun
authors: J
authors: Liu
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. 304921241@qq.com.
authors: Yunfei
authors: Y
authors: Huang
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. 290866079@qq.com.
authors: Yibin
authors: Y
authors: Meng
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. 731624568@qq.com.
authors: Wentao
authors: W
authors: Wang
authors: Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China. 541376519@qq.com.
authors: Dingjun
authors: D
authors: Hao
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016063:Blood Loss, Surgical; D001863:Bone Screws; D016025:Bone Transplantation; D003131:Combined Modality Therapy; D003646:Debridement; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000382:microbiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000295:instrumentation; D016348:Osseointegration; D056888:Patient Positioning; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents