Objective   To investigate the efficacy and safety of individual anti-tuberculous chemotherapy guided by drug susceptibility testing for spinal tuberculosis by analyzing the post-operative follow-up outcomes.    Methods   In this series

the diagnoses of spinal tuberculosis were established based on clinical

radiological and histological arguments in 46 patients who were admitted from August 2005 to March 2009. Their specimens (pus or caseous tissue) were collected during surgery. After processed in a routine mycobacteriology laboratory procedure

the specimens were inoculated into vials of the BACT/ALERT 3D system. The drug susceptibility testing was performed using absolute concentration method

which included 11 first and second line drugs. Four or five anti-tuberculous drug regimen was chosen according to the results of drug susceptibility testing. All the patients were followed up regularly a month later

and then every 3 months for the following 11 months

and subsequently at intervals of half a year. The clinical status

erythrocyte sedimentation rate (ESR)

roentgenogram and 3D-CT were concerned to estimate the progress of tuberculosis. Radiographs were analyzed before surgery

immediately after surgery

and at the final follow-up examination to assess the result of anterior fusion and maintenance of correction.    Results   Nineteen of the total 46 specimens were culture positive (41.3%). The average detection time to report drug susceptibility was 42 d (ranging from 30 to 58 d). The drug susceptibility testing showed a resistance level of 10.8% for isoniazid

2.1% for rifampicin and ethambutol

6.52% for streptomycin

4.34% for dipasic and 17.396% for levofloxacin. Four patients with gastrointestinal reaction and 1 with anti-tuberculosis drug-induced hepatitis completed a 12 months’ therapy

and the others received a 18 month’ therapy. The mean follow-up period was 25 months (ranging from 18 to 44 months)

and no obvious loss of deformity correction was observed. According to Bridwell criteria

grade Ⅰbony fusion was obtained in all patients in 9 to 12 months.    Conclusion   If guided by drug susceptibility testing

individual anti-tuberculous chemotherapy for 12 to 18 months is effective and safe for spinal tuberculosis.