Banga Ravinder Kumar, Singh Jagdeep, Dahuja Anshul, Garg Radhe Shyam
Department of Orthopaedics, Government Medical College, Patiala, Punjab, India.
Department of orthopaedics, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
Open Orthop J. 2018 Sep 28;12:380-388. doi: 10.2174/1874325001812010380. eCollection 2018.
Prospective randomised control trial.
To compare the effectiveness of Directly Observed Treatment and Short Course (DOTS) and Daily Anti Tubercular Therapy (ATT) in spinal tuberculosis with no neurological deficit.
Spinal tuberculosis is rampant in India with a major cause of morbidity and mortality. There is a lot of conflict regarding management with anti tubercular drugs, the regimen to be followed and the duration the drugs needed for complete cure.
This prospective study was conducted during the period of 2006 to 2009. Thirty cases of spinal tuberculosis were randomly divided equally into two groups of fifteen each and treated with DOTS and Daily ATT and compared at the end of follow up on clinical, radiological and Erythrocyte Sedimentation Rate values (ESR).
Pain score on Visual Analogue Scale (VAS) exhibits that mean pain score was 5.93+_1.54 at start and 0.64+_1.01 at the end of follow up with 89.39% change with DOTS therapy whereas mean pain score was 7.08 +_1.61at start of therapy and 0.69+_0.95 at end of follow up with 91.73% change in patients treated with Daily ATT with value >0.05 (not significant). The radiological recovery in patients with DOTS and Daily ATT have similar results after 1.5 years with p value > 0.05 showing that the radiological recovery by both treatment modalities are comparable. Mean change in ESR scores in DOTS therapy patients and patients on daily ATT were 74.57+_9.34% and 75.69+_9.38% change with p value >0.05 which was not significant.
DOTS therapy is an effective means of management of spinal tuberculosis cases with no neurological involvement, however its efficacy in patients with neurological deficit is further to be evaluated.
前瞻性随机对照试验。
比较直接观察治疗短程化疗（DOTS）和每日抗结核治疗（ATT）在无神经功能缺损的脊柱结核中的疗效。
脊柱结核在印度猖獗，是发病和死亡的主要原因。在抗结核药物治疗、应遵循的治疗方案以及完全治愈所需药物的持续时间方面存在很多争议。
这项前瞻性研究于2006年至2009年期间进行。30例脊柱结核患者被随机平均分为两组，每组15例，分别接受DOTS和每日ATT治疗，并在随访结束时对临床、放射学和红细胞沉降率（ESR）值进行比较。
视觉模拟量表（VAS）疼痛评分显示，DOTS治疗组开始时平均疼痛评分为5.93±1.54，随访结束时为0.64±1.01，变化率为89.39%；而每日ATT治疗组治疗开始时平均疼痛评分为7.08±1.61，随访结束时为0.69±0.95，变化率为91.73%，P值>0.05（无统计学意义）。1.5年后DOTS组和每日ATT组患者的放射学恢复情况相似，P值>0.05，表明两种治疗方式的放射学恢复情况具有可比性。DOTS治疗组患者和每日ATT治疗组患者ESR评分的平均变化分别为74.57±9.34%和75.69±9.38%，P值>0.05，无统计学意义。
DOTS疗法是治疗无神经受累脊柱结核病例的有效方法，但其在有神经功能缺损患者中的疗效有待进一步评估。
