Medical management of spinal tuberculosis: An experience from Pakistan

Abstract

Study Design: A prospective study on spinal tuberculosis conducted at Fauji Foundation Hospital, Rawalpindi, Pakistan, with 1 year of follow-up. Objective: The main aim was to diagnose spinal tuberculosis on clinical grounds and with simple noninvasive laboratory and radiology investigations and to treat the patients with antituberculosis drugs. Summary of Background Data: Spinal tuberculosis associated with any neuro deficit is usually treated by surgery. Medical treatment can reverse most of the neuro deficit. Surgery should not be the first choice of treatment. Methods: Twenty-six patients with spinal tuberculosis were clinically diagnosed, were started on antituberculosis treatment, and were followed up for 12 months. Results: Backache is the most common symptom. Thirty-eight percent of patients presented with neuro deficit in the form of paraplegia and quadriplegia. Erythrocyte sedimentation rate was high in 100% cases. Plain radiograph diagnosed the disease in 88.2 % patients. Eighty-five percent of cases completely improved on medical treatment without any surgical intervention. Conclusion: Uncomplicated spinal tuberculosis is a medical problem. The study shows that surgical intervention is not always necessary. © 2010, Lippincott Williams & Wilkins.