Skip to main content


Log in

Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation

  • Chinese section
  • Published:
European Spine Journal Aims and scope Submit manuscript



This study aimed to explore the feasibility of ultra-short-course chemotherapy in the treatment of spinal tuberculosis.


One hundred and eighty-five patients with confirmed spinal tuberculosis and surgical indication were included. The chemotherapy regimen was 2SHRZ/XHRZ. According to the duration of the chemotherapy, the patients were divided into two groups, the ultra-short-course chemotherapy group with an average duration of 4.5 months, and the standard chemotherapy group with an average duration of 9 months. The same surgery was performed for patients in the two groups.


The duration of the follow-up ranged from 61 to 87 months, with an average of 69.1 months. Erythrocyte sedimentation rate and C-reactive protein, kyphosis and nerve function, recovery of work, and activities of daily living were not significantly different between the two groups before or after treatment; however, the aforementioned indices were significantly different before and after treatment within groups. There was no significant difference in postoperative bone graft healing between the two groups. The drug side effects were significantly different between the two groups.


With thorough focus debridement, bone grafting, and internal fixation, the efficacy of ultra-short chemotherapy was similar to that of standard chemotherapy for the treatment of spinal tuberculosis. The ultra-short-course chemotherapy can shorten the course of treatment and reduce drug side effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Jain AK (2010) Tuberculosis of the spine: a fresh look at an old disease. J Bone Joint Surg Br 92(7):905–913

    Article  PubMed  CAS  Google Scholar 

  2. Tuli SM (2007) Tuberculosis of the spine: a historical review. Clin Orthop Relat Res 460:29–38

    PubMed  CAS  Google Scholar 

  3. Won Park Dae, Sohn JW, Kim E-H et al (2007) Outcome and management of spinal tuberculosis according to the severity of disease. Spine 32(4):E130–E135

    Article  Google Scholar 

  4. Rosenthal IM, Zhang M, Williams KN et al (2007) Daily dosing of rifapentine cures tuberculosis in three months or less in the murine model. PLoS Med. 4(12):e344

    Article  PubMed  Google Scholar 

  5. Davies GR, Nuermberger EL (2008) Pharmacokinetics and pharmacodynamics in the development of anti-tuberculosis drugs. Tuberculosis (Edinb) 88(S1):S65–S74

    Article  CAS  Google Scholar 

  6. Nuermberger EL, Spigelman MK, Yew WW (2010) Current development and future prospects in chemotherapy of tuberculosis. Respirology 15(5):764–778

    Article  PubMed  Google Scholar 

  7. Young DB, Perkins MD, Duncan K (2008) Confronting the scientific obstacles to global control of tuberculosis. J Clin Invest 118(4):1255–1265

    Article  PubMed  CAS  Google Scholar 

  8. Kreis B, Pretet S, Birenbaum J et al (1976) Two three-month treatment regimens for pulmonary tuberculosis. Bull Int Union Tuberc 51(1):71–75

    PubMed  CAS  Google Scholar 

  9. National Collaborative Group of short-course chemotherapy for pulmonary tuberculosis (1998) Five-month short-course chemotherapy and six-month whole-course intermittent regimen for the treatment of smear-positive pulmonary tuberculosis: a controlled clinical study. Chin J Tuberc Respir Dis 21:388–391

    Google Scholar 

  10. Wang Z, Ge Z, Jin W et al (2007) Treatment of spinal tuberculosis with ultrashort-course chemotherapy in conjunction with partial excision of pathologic vertebrae. Spine J. 7(6):671–681

    Article  PubMed  CAS  Google Scholar 

  11. Moon MS, Woo YK, Lee KS et al (1995) Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine 20:1910–1916

    Article  PubMed  CAS  Google Scholar 

  12. Xia A, Zhan S (2007) Comprehensive analysis of the incidence of anti-tuberculosis drug-induced adverse reactions in China. Chin J Tuberc Respir Dis 30:419–423

    Google Scholar 

  13. Jin W, Wang Z, Ma X et al (2009) Clinical analysis of side effects of anti-tuberculosis drugs in 156 patients with spinal tuberculosis. Trans Third Military Med Univ 31:1932–1936

    Google Scholar 

  14. East African/British Medical Reasearch Council (1972) Controlled clinical trial of short-course (6-month) regimens of chemotherapy for treatmen of pulmonary tuberculosis. Lanced, 1:1079–1085

    Google Scholar 

  15. Cattamanchi A, Dantes RB, Metcalfe JZ et al (2009) Clinical characteristics and treatment outcomes of patients with isoniazid-monoresistant tuberculosis. Clin Infect Dis 48(2):179–185

    Article  PubMed  Google Scholar 

  16. Swaminathan S, Deivanayagam CN, Rajasekaran S et al (2008) Long term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy. Natl Med J India 21(1):3–8

    PubMed  Google Scholar 

  17. Guo LX, Ma YZ, Chen X et al (2010) Clinical study of short-course chemotherapy combined with radical operation in retreating spinal tuberculosis. Zhongguo Gu Shang. 23(7):491–494

    PubMed  Google Scholar 

  18. Parthasarathy R, Sriram K, Santha T et al (1999) Short-course chemotherapy for tuberculosis of the spine A comparison between ambulant treatmentand radical surgery-ten-year report. J BoneJoint Surge (Br). 81:464–471

    Article  CAS  Google Scholar 

  19. Xiao C, Fu Y, Li Z et al (1997) Initial studies on short-course chemotherapy with irregular chemotherapeutic terms. Chin J Tuberc Respir 20:258–260

    Google Scholar 

  20. Blumberg HM, Burman WJ, Chaisson RE et al (2003) American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 167:603–662

    Article  PubMed  Google Scholar 

  21. Arora S, Sabat D, Maini L et al (2011) The results of nonoperative treatment of craniovertebral junction tuberculosis: a review of twenty-six cases. J Bone Joint Surg Am 93(6):540–547

    Article  PubMed  Google Scholar 

  22. Mwachaka PM, Ranketi SS et al (2011) Spinal tuberculosis among human immunodeficiency virus-negative patients in a Kenyan tertiary hospital: a 5-year synopsis. Spine J. 11(4):265–269

    Article  PubMed  Google Scholar 

  23. Hoffman EB, Crosier JH, Cremin BJ (1993) Imaging in children with spinal tuberculosis: a comparison of radiography, computed tomography and magnetic resonance imaging. J Bone Joint Surg [Br] 75-B:233–239

    Google Scholar 

  24. Ge Z, Wang Z, Wei M (2008) Measurement of the concentration of three antituberculosis drugs in the focus of spinal tuberculosis. Eur Spine J 17(11):1482–1487

    Article  PubMed  Google Scholar 

  25. Erturer E, Tezer M, Aydogan M et al (2010) The results of simultaneous posterior-anterior-posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis. Eur Spine J 19(12):2209–2215

    Article  PubMed  Google Scholar 

  26. Moon MS, Kim SS, Lee BJ et al (2011) Surgical management of severe rigid tuberculous kyphosis of dorsolumbar spine. Int Orthop 35(1):75–81

    Article  PubMed  Google Scholar 

  27. Erturer E, Tezer M, Aydogan M et al (2010) The results of simultaneous posterior-anterior-posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis. Eur Spine J 19(12):2209–2215

    Article  PubMed  Google Scholar 

  28. Wang Y, Zhang Y, Zhang X et al (2009) Posterior-only multilevel modified vertebral column resection for extremely severe Pott’s kyphotic deformity. Eur Spine J 18(10):1436–1441

    Article  PubMed  Google Scholar 

  29. Steffen R, Menzies D, Oxlade O et al (2010) Patients’ costs and cost-effectiveness of tuberculosis treatment in DOTS and non-DOTS facilities in Rio de Janeiro, Brazil. PLoS ONE 5(11):e14014

    Article  PubMed  Google Scholar 

Download references

Conflict of interest


Author information

Authors and Affiliations


Corresponding author

Correspondence to Jiandang Shi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, Z., Shi, J., Geng, G. et al. Ultra-short-course chemotherapy for spinal tuberculosis: five years of observation. Eur Spine J 22, 274–281 (2013).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: