The final results up to 15 years are reported of clinical trials of the management of tuberculosis of the spine in Korea and Hong Kong.
In Korea, 350 patients with active spinal tuberculosis were randomised to ambulatory chemotherapy or bed rest in hospital (in Masan) or a plaster-of-Paris jacket for nine months (in Pusan).
Patients in both centres were also randomised to either PAS plus isoniazid for 18 months or to the same drugs plus streptomycin for the first three months.
In Hong Kong, all 150 patients were treated with the three-drug regime and randomised to either radical excision of the spinal lesion with bone graft or open debridement.
On average, the disease was more extensive in Korea, but at 15 years (or 13 or 14 years in a proportion of the patients in Korea) the great majority of patients in both countries achieved a favourable status, no evidence of CNS involvement, no radiological evidence of disease, no sinus or clinically evident abscess, and no restriction of normal physical activity.
Most patients had already achieved a favourable status much earlier.
The earlier results of these trials are confirmed by the long-term follow-up with no late relapse or late-onset paraplegia.
The results of chemotherapy on an outpatient basis were not improved by bed rest or a plaster jacket and the only advantage of the radical operation was less late deformity compared with debridement. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Rachis, Traitement, Antituberculeux, Chimiothérapie, Traitement associé, Traitement orthopédique, Chirurgie orthopédique, Technique, Epidémiologie, Corée, Asie, Hong Kong, Chine, Pronostic, Homme, Long terme, Essai clinique, Système ostéoarticulaire pathologie, Rachis pathologie
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Spine, Treatment, Antituberculous agent, Chemotherapy, Combined treatment, Orthopedic treatment, Orthopedic surgery, Technique, Epidemiology, Korea, Asia, Hong Kong, China, Prognosis, Human, Long term, Clinical trial, Diseases of the osteoarticular system, Spine disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0267295
Code Inist : 002B05B02O. Création : 11/09/1998.