Five-year findings of comparisons of ambulatory short-course chemotherapy with radical surgery plus chemotherapy for tuberculosis of the spine in Madras.
Reetha, A.M.; Sivasubramanian, S.; Parthasarathy, R.; Somasundaram, P.R.; Prabhakar, R.
Indian Journal of Orthopaedics; 1994; 28; 7-13.
A controlled clinical trial was undertaken to compare the efficacy of short course chemotherapy given alone or combined with radical surgery in the treatment of spinal tuberculosis without paraplegia. Patients with active spinal tuberculosis involving the vertebral bodies and without paraplegia were randomly allocated to one of the following three regimens. (a) Rad 6: Radical anterior resection with bone grafting plus six; months of daily isoniazid and rifampicin. (b) Amb 6: Ambulatory chemotherapy with six months of daily isoniazid and rifampicin, without surgery. (c) Amb 9: Same as (b) but the duration being nine months.
The patients were intensively followed up for five years from the start. At five years, 98% of 86 Amb 9, 91% of 82 Amb 6 and 88% of 82 Rad 6 patients had a favourable status. It is concluded that ambulatory chemotherapy for 6 or 9 months is highly effective in the treatment of spinal tuberculosis. Radical surgery did not enhance the efficacy of the short course regimen.
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