Objective   To explore the indication and efficiency of raising drug content in the tuberculous lesions with minimal invasive surgery (MIS).    Methods   A total of 210 patients with spinal tuberculosis admitted from Jan. 2001 to Dec. 2007 and received surgical treatment were retrospectively analyzed. The patients were divided into 3 groups according to the approach they got. Group A (166 patients

79.05%)

including 20 patients with nerve compression

received simply MIS. MIS was carried out by placing injecting tube and double lumen lavage tube in the lesions to flow abscess under CT guidance. Then clinical therapy of regular or continuous medical injection was applied. Group B included 35 patients who received combination of opened surgery and MIS

among whom there were 13 patients with nerve compression. There were 19 patients receiving open surgery after placing lavage tube into lesion

and the left 16 patients received local medical injection after open surgery

lasting 2 to 3 weeks. The method to raise drug content in the lesions was to place epidural tube through percutaneous puncture. Then local medical injection and/or lavage through double lumen tube were given

and this therapy spanned 2 to 4 months. Drugs for local injection were isoniazid

streptomycin and rifampin. Group C had 9 patients who only received open surgery

and there were 5 patients with nerve compression among them. Methods of open surgery were anterior

posterior or the combination of the 2 ways.    Results   In group A

all lavage tubes were placed smoothly

and no complication was discovered pre- and post-operatively. The local chemotherapy time was 56±15 d. There was no sinus and cross infection near tubes. During the follow-up of 1.5 to 7.5 years

the patients without nerve compression had recovered completely

16 cases with spinal nerve damage were fully recovered and the rest 4 cases were improved. Patients without spinal nerve damage in group B have recovered while 2 ASIA A level patients were not cured. In group C

patients without spinal nerve damage were fully recovered

and 1 ASIA A patients died in perioperative period.    Conclusion   Raising drug content in the tuberculous lesions by MIS is a main method in treating spinal tuberculosis

while open technique still plays important role in treating severe spinal tuberculosis.