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Ultrashort-Course Chemotherapy Cures Spinal Tuberculosis

Fewer complications than longer courses of chemotherapy

THURSDAY, Nov. 29 (HealthDay News) -- Patients with spinal tuberculosis who undergo surgery and an ultrashort-course of chemotherapy for less than six months achieve a complete clinical cure with fewer complications than patients on longer chemotherapy regimens, according to a report in the November/December issue of The Spine Journal.

Zili Wang, M.D., and colleagues from the Hospital of the Ningxia Medical School in China reviewed the results from 76 cases of spinal tuberculosis treated from 1998-2003 by chemotherapy in conjunction with partial excision of pathological vertebrae. Of these, 25 patients had standard chemotherapy, 23 had short-course chemotherapy, and 28 had ultrashort-course chemotherapy of less than six months.

The researchers found that all patients were completely clinically cured as assessed by clinical manifestations, laboratory tests, imaging tests and ultrasonic wave B tests. However, major drug complications occurred in only 18 percent of ultrashort-course chemotherapy patients, compared with 65 percent of short-course chemotherapy patients and 76 percent of standard chemotherapy patients. None of the patients on ultrashort-course chemotherapy had lasting chemotherapeutic lesions of the liver, kidney or permanent nervus vestibularis, compared with three short-course chemotherapy patients and five standard chemotherapy patients.

"Ultrashort-course chemotherapy in conjunction with anterior partial excisions of pathological vertebrae, large iliac strut graft, and anterior or posterior internal instrumental fixation achieved excellent clinical results and the lowest complication rate of antituberculosis chemotherapy," Wang and colleagues conclude.

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