title: The outcomes of chemotherapy only treatment on mild spinal tuberculosis.
abstract: BACKGROUND
  The treatments for spinal tuberculosis (TB) patients without absolute surgical indications have been controversial. Some people believed that most spinal TB patients were indicated for surgery, while other people believed in chemotherapy only. To help clarify the treatment over spinal TB patients without absolute surgical indications, we characterized a subtype spinal TB and then analyzed the treatment outcomes of standard chemotherapy alone.
  
  
  METHODS
  In this retrospective study, 740 adult patients of spinal TB from January 2005 to January 2013 in our institution were reviewed. Patients who fit into the characterizations of mild spinal TB were started by standard chemotherapy for 18 months and followed up for at least 2 years upon the completion of treatment. The overall outcome, neurological function, local kyphosis, and level of pain at different time points were assessed.
  
  
  RESULTS
  After starting the conservative treatment, 89 out of 740 patients were chosen for chemotherapy alone, and all patients were followed up for at least 2 years (ranging from 24 to 50 months) upon the completion of the treatment. Of 89 patients, 95.4 % of patients showed a definite and clinical response within 1 month after starting the treatment, 69 % of patients had excellent to good results, with no complications of the disease, and 77.5 % had asymptomatic local kyphosis with intact neurological function; solid bony fusion of adjacent segment was achieved in 88.8 % of patients.
  
  
  CONCLUSIONS
  We believe that the mild spinal TB respond well to the standard chemotherapy, and the detailed description of mild TB would provide crucial guidance in determination of conservative treatment.
authors.affiliation: Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Zehua
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Luo
authors.affiliation: Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Dai
authors.affiliation: Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China. sumersun07@126.com.
authors.forename: Dong
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China. xjzslw@163.com.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage; D007738:Kyphosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011718:Pyrazinamide / Q000008:administration & dosage; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid
keywords: Mild spinal tuberculosis; Standard chemotherapy alone; Treatment outcome