Tuli S M
J Bone Joint Surg Br. 1975 Feb;57(1):13-23.
The efficacy of modern drugs in the treatment of tuberculosis of the spine has been evaluated by a personal follow-up for three to ten years. Operation on the vertebral lesion was done only for those patients with or without neural complications who failed to respond favourably to drug therapy and rest. Thus absolute indications for operation were present in only 6 per cent of cases without neural involvement and in 60 per cent of patients with neural deficit. Of patients who responded to drug therapy alone, only 19 per cent revealed increase of kyphosis by more than 10 degrees. The diseased area showed radiological evidence of osseous replacement of 29-6 per cent of cases, of fibro-osseous union in 50 per cent and of fibrous replacement in 20-2 per cent. The overall results of this regime compare favourably with those of radical operation. It is suggested that treatment should in the first place be by modern antitubercular drugs.
通过对患者进行三到十年的个人随访，评估了现代药物治疗脊柱结核的疗效。仅对那些药物治疗和休息后无良好反应、有或无神经并发症的患者进行椎体病变手术。因此，在无神经受累的病例中，仅6%有绝对手术指征，而在有神经功能缺损的患者中，这一比例为60%。仅接受药物治疗的患者中，只有19%的患者后凸增加超过10度。病变区域影像学显示骨替代占29.6%的病例，纤维骨联合占50%，纤维替代占20.2%。该治疗方案的总体结果与根治性手术相比具有优势。建议首先采用现代抗结核药物进行治疗。
