• Peng Zhang, Yong Shen, Wen-Yuan Ding, Wei Zhang, and Zikun Shang.
• Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, China.
• Arch Orthop Trauma Surg. 2014 Feb 1; 134 (2): 167-72.

PurposeTo 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.MethodsData 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.ResultsAfter 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).ConclusionsIt 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.

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