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Routine surgery in addition to chemotherapy for treating spinal tuberculosis

  1. Paul C Jutte1,*,
  2. Joke H van Loenhout-Rooyackers2

Editorial Group: Cochrane Infectious Diseases Group

Published Online: 17 MAR 2010

Assessed as up-to-date: 21 OCT 2007

DOI: 10.1002/14651858.CD004532.pub2

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Additional Information

How to Cite

Jutte PC, van Loenhout-Rooyackers JH. Routine surgery in addition to chemotherapy for treating spinal tuberculosis. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD004532. DOI: 10.1002/14651858.CD004532.pub2.

Author Information

  1. 1

    University Medical Center Groningen, Groningen, Netherlands

  2. 2

    GGD Regio Nijmegen (Public Health Office), Department of Tuberculosis, Nijmegen, Netherlands

*Paul C Jutte, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, Groningen, 9700 RB, Netherlands. p.c.jutte@orth.umcg.nl.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 17 MAR 2010

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
ICMR/MRC 1989 {published data only}
  • Balasubramanian R, Sivasubramanian S, Parthasarathy R, Santha T, Somasundaram PR, Shanmugasundaram TK, et al. Prevalence, incidence and resolution of abscesses and sinuses in patients with tuberculosis of the spine: 5-year results of patients treated with short-course chemotherapy with or without surgery in Madras. Indian Journal of Tuberculosis 1994;41(3):151-60.
  • Indian Council of Medical Research/British Medical Research Council Working Party. A controlled trial of short-course regimens of chemotherapy in patients receiving ambulatory treatment or undergoing radical surgery for tuberculosis of the spine. Indian Journal of Tuberculosis 1989;36 Suppl:1-21.
  • Medical Research Council Working Party on Tuberculosis of the Spine. Five-year assessment of controlled trials of short-course chemotherapy regimens of 6, 9 or 18 months' duration for spinal tuberculosis in patients ambulatory from the start or undergoing radical surgery. Fourteenth report of the Medical Research Council Working Party on Tuberculosis of the Spine. International Orthopaedics 1999;23(2):73-81.
  • Parthasarathy R, Sriram K, Santha T, Prabhakar R, Somasundaram PR, Sivasubramanian S. Short-course chemotherapy for tuberculosis of the spine. A comparison between ambulant treatment and radical surgery--ten-year report. Journal of Bone and Joint Surgery 1999;81-B(3):464-71.
  • Reetha AM, Sivasubramanian S, Parthasarathy R, Somasundaram PR, Prabhakar R. Five-year findings of a comparison of ambulatory short-course chemotherapy with radical surgery plus chemotherapy for tuberculosis of the spine in Madras. Indian Journal of Orthopaedics 1994;28(1):7-13.
MRC 1974a {published data only}
  • Anonymous. A controlled trial of debridement and ambulatory treatment in the management of tuberculosis of the spine in patients on standard chemotherapy. A study in Bulawayo, Rhodesia. Journal of Tropical Medicine and Hygeine 1974;77(4):72-92.
  • Medical Research Council Working Party on Tuberculosis of the Spine. Five-year assessments of controlled trials of ambulatory treatment, debridement and anterior spinal fusion in the management of tuberculosis of the spine. Studies in Bulawayo (Rhodesia) and in Hong Kong. Sixth report of the Medical Research Council Working Party on Tuberculosis of the Spine. Journal of Bone and Joint Surgery 1978;60-B(2):163-77.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Jain 2004 {published data only}
Loembe 1994 {published data only}
  • Loembe PM. Medico-surgical treatment of Pott's disease. Our attitude in Gabon [Traitement medico-chirurgical du mal de Pott de l'adulte. Notre attitude a Gabon]. Le Journal Canadien des Sciences Neurologiques 1994;21(4):339-45.
MRC 1973a {published data only}
  • No authors listed. A controlled trial of ambulant out-patient treatment and in-patient rest in bed in the management of tuberculosis of the spine in young Korean patients on standard chemotherapy a study in Masan, Korea. First report of the Medical Research Council Working Party on Tuberculosis of the Spine. Journal of Bone and Joint Surgery 1973;55-B(4):678-97.
MRC 1973b {published data only}
  • Medical Research Council Working Party on Tuberculosis of the Spine. A controlled trial of plaster-of-paris jackets in the management of ambulant outpatient treatment of tuberculosis of the spine in children on standard chemotherapy. A study in Pusan, Korea. Second report of the Medical Research Council Working Party on Tuberculosis of the Spine. Tubercle 1973;54(4):261-82.
MRC 1974b {published data only}
  • A controlled trial of anterior spinal fusion and debridement in the surgical management of tuberculosis of the spine in patients on standard chemotherapy: a study in Hong Kong. British Journal of Surgery 1974;61(11):853-66.
    Direct Link:
MRC 1976 {published data only}
  • Medical Research Council Working Party on tuberculosis of the spine. A five-year assessment of controlled trials of in-patient and out-patient treatment and of plaster-of-Paris jackets for tuberculosis of the spine in children on standard chemotherapy. Studies in Masan and Pusan, Korea. Fifth report of the Medical Research Council Working Party on tuberculosis of the spine. Journal of Bone and Joint Surgery 1976;58-B(4):399-411.
MRC 1978a {published data only}
  • Medical Research Council Working Party on tuberculosis of the spine. A controlled trial of anterior spinal fusion and debridement in the surgical management of tuberculosis of the spine in patients on standard chemotherapy: a study in two centres in South Africa. Seventh Report of the Medical Research Council Working Party on tuberculosis of the spine. Tubercle 1978;59(2):79-105.
  • Rauch RN. Proceedings: Spinal caries: surgical debridement versus radical resection and bonegrafting. Journal of Bone and Joint Surgery 1975;57-B(2):261-2.
MRC 1982 {published data only}
  • Medical Research Council Working Party on Tuberculosis of the Spine. A 10-year assessment of a controlled trial comparing debridement and anterior spinal fusion in the management of tuberculosis of the spine in patients on standard chemotherapy in Hong Kong. Eighth Report of the Medical Research Council Working Party on Tuberculosis of the Spine. Journal of Bone and Joint Surgery 1982;64-B(4):393-8.
MRC 1985 {published data only}
  • Medical Research Council Working Party on Tuberculosis of the Spine. A 10-year assessment of controlled trials of inpatient and outpatient treatment and of plaster-of-Paris jackets for tuberculosis of the spine in children on standard chemotherapy. Studies in Masan and Pusan, Korea. Ninth report of the Medical Research Council Working Party on Tuberculosis of the Spine. Journal of Bone and Joint Surgery 1985;67-B(1):103-10.
MRC 1986 {published data only}
  • Medical Research Council Working Party on Tuberculosis of the Spine. Original Title:. Tubercle 1986;67(4):243-59.
MRC 1993 {published data only}
  • Medical Research Council Working Party on Tuberculosis of the Spine. Controlled trial of short-course regimens of chemotherapy in the ambulatory treatment of spinal tuberculosis. Results at three years of a study in Korea. Twelfth report of the Medical Research Council Working Party on Tuberculosis of the Spine. Journal of Bone and Joint Surgery 1993;75-B(2):240-8.
MRC 1998 {published data only}
  • Medical Research Council Working Party on Tuberculosis of the Spine. A 15-year assessment of controlled trials of the management of tuberculosis of the spine in Korea and Hong Kong. Thirteenth Report of the Medical Research Council Working Party on Tuberculosis of the Spine. Journal of Bone and Joint Surgery 1998;80-B(3):456-62.
Rajasekaran 1998 {published data only}
  • Rajasekaran S, Shanmugasundaram TK, Prabhakar R, Dheenadhayalan J, Shetty AP, Shetty DK. Tuberculous lesions of the lumbosacral region. A 15-year follow-up of patients treated by ambulant chemotherapy. Spine 1998;23(10):1163-7.
Rajeswari 1997b {published data only}
  • Rajeswari R, Balasubramanian R, Venkatesan P, Sivasubramanian S, Soundarapandian S, Shanmugasundaram TK, et al. Short-course chemotherapy in the treatment of Pott's paraplegia: report on five year follow-up. International Journal of Tuberculosis and Lung Disease 1997;1(2):152-8.
Seddon 1976 {published data only}
Upadhyay 1993 {published data only}
  • Upadhyay SS, Sell P, Saji MJ, Sell B, Yau AC, Leong JC. 17-year prospective study of surgical management of spinal tuberculosis in children. Hong Kong operation compared with debridement surgery for short- and long-term outcome of deformity. Spine 1993;18(12):1704-11.
Upadhyay 1994a {published data only}
  • Upadhyay SS, Saji MJ, Sell P, Sell B, Hsu LC. Spinal deformity after childhood surgery for tuberculosis of the spine. A comparison of radical surgery and debridement. Journal of Bone and Joint Surgery 1994;76-B(1):91-8.
Upadhyay 1994b {published data only}
  • Upadhyay SS, Saji MJ, Sell P, Sell B, Yau AC. Longitudinal changes in spinal deformity after anterior spinal surgery for tuberculosis of the spine in adults. A comparative analysis between radical and debridement surgery. Spine 1994;19(5):542-9.
Upadhyay 1994c {published data only}
  • Upadhyay SS, Sell P, Saji MJ, Sell B, Hsu LC. Surgical management of spinal tuberculosis in adults. Hong Kong operation compared with debridement surgery for short and long term outcome of deformity. Clinical Orthopaedics and Related Research 1994;May(302):173-82.
Upadhyay 1996 {published data only}

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Bass 1994
  • Bass JB Jr, Farer LS, Hopewell PC, O'Brien R, Jacobs RF, Ruben F, et al. Treatment of tuberculosis and tuberculosis infection in adults and children. American Thoracic Society and The Centers for Disease Control and Prevention. American Journal of Respiratory and Critical Care Medicine 1994;149(5):1359-74.
Boachie-Adjei 1996
BTS 1998
  • Chemotherapy and management of tuberculosis in the United Kingdom: recommendations 1998. Joint Tuberculosis Committee of the British Thoracic Society. Thorax 1998;53(7):536-48.
Chen 1995
Fardon 2002
  • Fardon DF, Garfin SR, editors. Orthopaedic knowledge update. Spine 2. 2nd Edition. Rosemont, Ill: American Academy of Orthopaedic Surgeons, 2002.
Govender 2000
  • Govender S, Annamalai K, Kumar KP, Govender UG. Spinal tuberculosis in HIV positive and negative patients: immunological response and clinical outcome. International Orthopaedics 2000;24(3):163-6.
Güven 1994
  • Güven O, Kumano K, Yalcin S, Karahan M, Tsuji S. A single stage posterior approach and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis. Spine 1994;19(9):1039-43.
Higgins 2005
  • Higgins JPT, Green S, editors. Highly sensitive search strategies for identifying reports of randomized controlled trials in MEDLINE. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated May 2005]; Appendix 5b. www.cochrane.org/resources/handbook/hbook.htm (accessed 1 October 2005).
Hodgson 1960
  • Hodgson AR, Stock FE. Anterior spine fusion for the treatment of tuberculosis of the spine. The operative findings and results of treatment in the first one hundred cases. Journal of Bone and Joint Surgery 1960;42A:295-310.
Hsu 1988
  • Hsu LC, Cheng CL, Leong JC. Pott's paraplegia of late onset. The cause of compression and the results of anterior decompression. Journal of Bone and Joint Surgery 1988;70-B(4):534-8.
Jellis 1996
Jutte 2002
Jüni 2001
Kaplan 1952
  • Kaplan CJ. Pott's disease in South African Bantu children; an analysis of results and comparison with Lancashire figures. British Journal of Tuberculosis 1952;46(4):209-13.
Konstam 1958
  • Konstam PG, Konstam ST. Spinal tuberculosis in Southern Nigeria with special reference to ambulant treatment of thoracolumbar disease. Journal of Bone and Joint Surgery 1958;40-B(1):26-32.
Konstam 1962
  • Konstam PG, Blesovsky A. The ambulant treatment of spinal tuberculosis. British Journal of Surgery 1962;50:26-38.
    Direct Link:
Lee 1999
  • Lee TC, Lu K, Yang LC, Huang HY, Liang CL. Transpedicular instrumentation as an adjunct in the treatment of thoracolumbar and lumbar spine tuberculosis with early stage bone destruction. Journal of Neurosurgery 1999;91(2 Suppl):163-9.
Leibert 1996
  • Leibert E, Schluger NW, Bonk S, Rom WN. Spinal tuberculosis in patients with human immunodeficiency virus infection: clinical presentation, therapy and outcome. Tuberculosis and Lung Disease 1996;77(4):329-34.
Leong 1993
Luk 1999
Martini 1976
  • Martini M, Hannachi MR, Ould M, Chaulet P. Chemotherapy in tuberculosis of the locomotor apparatus. Results in 252 cases. Acta Orthopaedica Belgica 1976;42(1):84-93.
Moon 1995
Moon 1997
MRC 1987
  • Five-year follow-up of a controlled trial of five 6-month regimens of chemotherapy for pulmonary tuberculosis. Hong Kong Chest Service/British Medical Research Council. American Review of Respiratory Disease 1987;136(6):1139-42.
Nene 2005
  • Nene A, Bhojraj S. Results of nonsurgical treatment of thoracic spinal tuberculosis in adults. The Spine Journal 2005;5(1):79-84.
Nussbaum 1995
Pattison 1986
Rajasekaran 1987
  • Rajasekaran S, Shanmugasundaram TK. Prediction of the angle of gibbus deformity in tuberculosis of the spine. Journal of Bone and Joint Surgery 1987;69-B(4):503-9.
Rajeswari 1997a
  • Rajeswari R, Ranjani R, Santha T, Sriram K, Prabhakar R. Late onset paraplegia--a sequela to Pott's disease. A report on imaging, prevention and management. International Journal of Tuberculosis and Lung Disease 1997;1(5):468-73.
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Rezai 1995
Seddon 1935
  • Seddon HJ. Pott's paraplegia; prognosis and treatment. British Journal of Surgery 1935;22(88):769-99.
    Direct Link:
Smith 1996
  • Smith IE, Laroche CM, Jamieson SA, Shneerson JM. Kyphosis secondary to tuberculous osteomyelitis as a cause of ventilatory failure. Clinical features, mechanisms, and management. Chest 1996;110(4):1105-10.
Sundararaj 2003
  • Sundararaj GD, Behera S, Ravi V, Venkatesh K, Cherian VM, Lee V. Role of posterior stabilisation in the management of tuberculosis of the dorsal and lumbar spine. Journal of Bone and Joint Surgery 2003;85-B(1):100-6.
Tuli 1975
  • Tuli SM. Results of treatment of spinal tuberculosis by "middle-path" regime. Journal of Bone and Joint Surgery 1975;57-B(1):13-23.
Turgut 2001
Van Loenhout 2002
  • Van Loenhout-Rooyackers JH, Verbeek AL, Jutte PC. Chemotherapeutic treatment for spinal tuberculosis. International Journal of Tuberculosis and Lung Disease 2002;6(3):259-65.
Vidyasagar 1994
  • Vidyasagar C, Murthy HK. Management of tuberculosis of the spine with neurological complications. Annals of the Royal College of Surgeons of England 1994;76(2):80-4.
Watts 1996
  • Watts HG, Lifeso RM. Tuberculosis of bone and joints. Journal of Bone and Joint Surgery 1996;78-A(2):288-98.
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  • World Health Organization. Global TB database. www.who.int/tb/country/global_tb_database/en/index.html (accessed August 2005).
Wimmer 1997
Özdemir 2003
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