Skip to main content
Top
Published in: European Spine Journal 2/2013

01-02-2013 | Chinese section

Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation

Authors: Zili Wang, Jiandang Shi, Guangqi Geng, Hongyan Qiu

Published in: European Spine Journal | Issue 2/2013

Login to get access

Abstract

Purpose

This study aimed to explore the feasibility of ultra-short-course chemotherapy in the treatment of spinal tuberculosis.

Methods

One hundred and eighty-five patients with confirmed spinal tuberculosis and surgical indication were included. The chemotherapy regimen was 2SHRZ/XHRZ. According to the duration of the chemotherapy, the patients were divided into two groups, the ultra-short-course chemotherapy group with an average duration of 4.5 months, and the standard chemotherapy group with an average duration of 9 months. The same surgery was performed for patients in the two groups.

Results

The duration of the follow-up ranged from 61 to 87 months, with an average of 69.1 months. Erythrocyte sedimentation rate and C-reactive protein, kyphosis and nerve function, recovery of work, and activities of daily living were not significantly different between the two groups before or after treatment; however, the aforementioned indices were significantly different before and after treatment within groups. There was no significant difference in postoperative bone graft healing between the two groups. The drug side effects were significantly different between the two groups.

Conclusions

With thorough focus debridement, bone grafting, and internal fixation, the efficacy of ultra-short chemotherapy was similar to that of standard chemotherapy for the treatment of spinal tuberculosis. The ultra-short-course chemotherapy can shorten the course of treatment and reduce drug side effects.
Literature
1.
go back to reference Jain AK (2010) Tuberculosis of the spine: a fresh look at an old disease. J Bone Joint Surg Br 92(7):905–913PubMedCrossRef Jain AK (2010) Tuberculosis of the spine: a fresh look at an old disease. J Bone Joint Surg Br 92(7):905–913PubMedCrossRef
2.
go back to reference Tuli SM (2007) Tuberculosis of the spine: a historical review. Clin Orthop Relat Res 460:29–38PubMed Tuli SM (2007) Tuberculosis of the spine: a historical review. Clin Orthop Relat Res 460:29–38PubMed
3.
go back to reference Won Park Dae, Sohn JW, Kim E-H et al (2007) Outcome and management of spinal tuberculosis according to the severity of disease. Spine 32(4):E130–E135CrossRef Won Park Dae, Sohn JW, Kim E-H et al (2007) Outcome and management of spinal tuberculosis according to the severity of disease. Spine 32(4):E130–E135CrossRef
4.
go back to reference Rosenthal IM, Zhang M, Williams KN et al (2007) Daily dosing of rifapentine cures tuberculosis in three months or less in the murine model. PLoS Med. 4(12):e344PubMedCrossRef Rosenthal IM, Zhang M, Williams KN et al (2007) Daily dosing of rifapentine cures tuberculosis in three months or less in the murine model. PLoS Med. 4(12):e344PubMedCrossRef
5.
go back to reference Davies GR, Nuermberger EL (2008) Pharmacokinetics and pharmacodynamics in the development of anti-tuberculosis drugs. Tuberculosis (Edinb) 88(S1):S65–S74CrossRef Davies GR, Nuermberger EL (2008) Pharmacokinetics and pharmacodynamics in the development of anti-tuberculosis drugs. Tuberculosis (Edinb) 88(S1):S65–S74CrossRef
6.
go back to reference Nuermberger EL, Spigelman MK, Yew WW (2010) Current development and future prospects in chemotherapy of tuberculosis. Respirology 15(5):764–778PubMedCrossRef Nuermberger EL, Spigelman MK, Yew WW (2010) Current development and future prospects in chemotherapy of tuberculosis. Respirology 15(5):764–778PubMedCrossRef
7.
go back to reference Young DB, Perkins MD, Duncan K (2008) Confronting the scientific obstacles to global control of tuberculosis. J Clin Invest 118(4):1255–1265PubMedCrossRef Young DB, Perkins MD, Duncan K (2008) Confronting the scientific obstacles to global control of tuberculosis. J Clin Invest 118(4):1255–1265PubMedCrossRef
8.
go back to reference Kreis B, Pretet S, Birenbaum J et al (1976) Two three-month treatment regimens for pulmonary tuberculosis. Bull Int Union Tuberc 51(1):71–75PubMed Kreis B, Pretet S, Birenbaum J et al (1976) Two three-month treatment regimens for pulmonary tuberculosis. Bull Int Union Tuberc 51(1):71–75PubMed
9.
go back to reference National Collaborative Group of short-course chemotherapy for pulmonary tuberculosis (1998) Five-month short-course chemotherapy and six-month whole-course intermittent regimen for the treatment of smear-positive pulmonary tuberculosis: a controlled clinical study. Chin J Tuberc Respir Dis 21:388–391 National Collaborative Group of short-course chemotherapy for pulmonary tuberculosis (1998) Five-month short-course chemotherapy and six-month whole-course intermittent regimen for the treatment of smear-positive pulmonary tuberculosis: a controlled clinical study. Chin J Tuberc Respir Dis 21:388–391
10.
go back to reference Wang Z, Ge Z, Jin W et al (2007) Treatment of spinal tuberculosis with ultrashort-course chemotherapy in conjunction with partial excision of pathologic vertebrae. Spine J. 7(6):671–681PubMedCrossRef Wang Z, Ge Z, Jin W et al (2007) Treatment of spinal tuberculosis with ultrashort-course chemotherapy in conjunction with partial excision of pathologic vertebrae. Spine J. 7(6):671–681PubMedCrossRef
11.
go back to reference Moon MS, Woo YK, Lee KS et al (1995) Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine 20:1910–1916PubMedCrossRef Moon MS, Woo YK, Lee KS et al (1995) Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine 20:1910–1916PubMedCrossRef
12.
go back to reference Xia A, Zhan S (2007) Comprehensive analysis of the incidence of anti-tuberculosis drug-induced adverse reactions in China. Chin J Tuberc Respir Dis 30:419–423 Xia A, Zhan S (2007) Comprehensive analysis of the incidence of anti-tuberculosis drug-induced adverse reactions in China. Chin J Tuberc Respir Dis 30:419–423
13.
go back to reference Jin W, Wang Z, Ma X et al (2009) Clinical analysis of side effects of anti-tuberculosis drugs in 156 patients with spinal tuberculosis. Trans Third Military Med Univ 31:1932–1936 Jin W, Wang Z, Ma X et al (2009) Clinical analysis of side effects of anti-tuberculosis drugs in 156 patients with spinal tuberculosis. Trans Third Military Med Univ 31:1932–1936
14.
go back to reference East African/British Medical Reasearch Council (1972) Controlled clinical trial of short-course (6-month) regimens of chemotherapy for treatmen of pulmonary tuberculosis. Lanced, 1:1079–1085 East African/British Medical Reasearch Council (1972) Controlled clinical trial of short-course (6-month) regimens of chemotherapy for treatmen of pulmonary tuberculosis. Lanced, 1:1079–1085
15.
go back to reference Cattamanchi A, Dantes RB, Metcalfe JZ et al (2009) Clinical characteristics and treatment outcomes of patients with isoniazid-monoresistant tuberculosis. Clin Infect Dis 48(2):179–185PubMedCrossRef Cattamanchi A, Dantes RB, Metcalfe JZ et al (2009) Clinical characteristics and treatment outcomes of patients with isoniazid-monoresistant tuberculosis. Clin Infect Dis 48(2):179–185PubMedCrossRef
16.
go back to reference Swaminathan S, Deivanayagam CN, Rajasekaran S et al (2008) Long term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy. Natl Med J India 21(1):3–8PubMed Swaminathan S, Deivanayagam CN, Rajasekaran S et al (2008) Long term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy. Natl Med J India 21(1):3–8PubMed
17.
go back to reference Guo LX, Ma YZ, Chen X et al (2010) Clinical study of short-course chemotherapy combined with radical operation in retreating spinal tuberculosis. Zhongguo Gu Shang. 23(7):491–494PubMed Guo LX, Ma YZ, Chen X et al (2010) Clinical study of short-course chemotherapy combined with radical operation in retreating spinal tuberculosis. Zhongguo Gu Shang. 23(7):491–494PubMed
18.
go back to reference Parthasarathy R, Sriram K, Santha T et al (1999) Short-course chemotherapy for tuberculosis of the spine A comparison between ambulant treatmentand radical surgery-ten-year report. J BoneJoint Surge (Br). 81:464–471CrossRef Parthasarathy R, Sriram K, Santha T et al (1999) Short-course chemotherapy for tuberculosis of the spine A comparison between ambulant treatmentand radical surgery-ten-year report. J BoneJoint Surge (Br). 81:464–471CrossRef
19.
go back to reference Xiao C, Fu Y, Li Z et al (1997) Initial studies on short-course chemotherapy with irregular chemotherapeutic terms. Chin J Tuberc Respir 20:258–260 Xiao C, Fu Y, Li Z et al (1997) Initial studies on short-course chemotherapy with irregular chemotherapeutic terms. Chin J Tuberc Respir 20:258–260
20.
go back to reference Blumberg HM, Burman WJ, Chaisson RE et al (2003) American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 167:603–662PubMedCrossRef Blumberg HM, Burman WJ, Chaisson RE et al (2003) American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 167:603–662PubMedCrossRef
21.
go back to reference Arora S, Sabat D, Maini L et al (2011) The results of nonoperative treatment of craniovertebral junction tuberculosis: a review of twenty-six cases. J Bone Joint Surg Am 93(6):540–547PubMedCrossRef Arora S, Sabat D, Maini L et al (2011) The results of nonoperative treatment of craniovertebral junction tuberculosis: a review of twenty-six cases. J Bone Joint Surg Am 93(6):540–547PubMedCrossRef
22.
go back to reference Mwachaka PM, Ranketi SS et al (2011) Spinal tuberculosis among human immunodeficiency virus-negative patients in a Kenyan tertiary hospital: a 5-year synopsis. Spine J. 11(4):265–269PubMedCrossRef Mwachaka PM, Ranketi SS et al (2011) Spinal tuberculosis among human immunodeficiency virus-negative patients in a Kenyan tertiary hospital: a 5-year synopsis. Spine J. 11(4):265–269PubMedCrossRef
23.
go back to reference Hoffman EB, Crosier JH, Cremin BJ (1993) Imaging in children with spinal tuberculosis: a comparison of radiography, computed tomography and magnetic resonance imaging. J Bone Joint Surg [Br] 75-B:233–239 Hoffman EB, Crosier JH, Cremin BJ (1993) Imaging in children with spinal tuberculosis: a comparison of radiography, computed tomography and magnetic resonance imaging. J Bone Joint Surg [Br] 75-B:233–239
24.
go back to reference Ge Z, Wang Z, Wei M (2008) Measurement of the concentration of three antituberculosis drugs in the focus of spinal tuberculosis. Eur Spine J 17(11):1482–1487PubMedCrossRef Ge Z, Wang Z, Wei M (2008) Measurement of the concentration of three antituberculosis drugs in the focus of spinal tuberculosis. Eur Spine J 17(11):1482–1487PubMedCrossRef
25.
go back to reference Erturer E, Tezer M, Aydogan M et al (2010) The results of simultaneous posterior-anterior-posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis. Eur Spine J 19(12):2209–2215PubMedCrossRef Erturer E, Tezer M, Aydogan M et al (2010) The results of simultaneous posterior-anterior-posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis. Eur Spine J 19(12):2209–2215PubMedCrossRef
26.
go back to reference Moon MS, Kim SS, Lee BJ et al (2011) Surgical management of severe rigid tuberculous kyphosis of dorsolumbar spine. Int Orthop 35(1):75–81PubMedCrossRef Moon MS, Kim SS, Lee BJ et al (2011) Surgical management of severe rigid tuberculous kyphosis of dorsolumbar spine. Int Orthop 35(1):75–81PubMedCrossRef
27.
go back to reference Erturer E, Tezer M, Aydogan M et al (2010) The results of simultaneous posterior-anterior-posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis. Eur Spine J 19(12):2209–2215PubMedCrossRef Erturer E, Tezer M, Aydogan M et al (2010) The results of simultaneous posterior-anterior-posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis. Eur Spine J 19(12):2209–2215PubMedCrossRef
28.
go back to reference Wang Y, Zhang Y, Zhang X et al (2009) Posterior-only multilevel modified vertebral column resection for extremely severe Pott’s kyphotic deformity. Eur Spine J 18(10):1436–1441PubMedCrossRef Wang Y, Zhang Y, Zhang X et al (2009) Posterior-only multilevel modified vertebral column resection for extremely severe Pott’s kyphotic deformity. Eur Spine J 18(10):1436–1441PubMedCrossRef
29.
go back to reference Steffen R, Menzies D, Oxlade O et al (2010) Patients’ costs and cost-effectiveness of tuberculosis treatment in DOTS and non-DOTS facilities in Rio de Janeiro, Brazil. PLoS ONE 5(11):e14014PubMedCrossRef Steffen R, Menzies D, Oxlade O et al (2010) Patients’ costs and cost-effectiveness of tuberculosis treatment in DOTS and non-DOTS facilities in Rio de Janeiro, Brazil. PLoS ONE 5(11):e14014PubMedCrossRef
Metadata
Title
Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation
Authors
Zili Wang
Jiandang Shi
Guangqi Geng
Hongyan Qiu
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 2/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2536-0

Other articles of this Issue 2/2013

European Spine Journal 2/2013 Go to the issue