An outcome study on conservative management of spinal tuberculosis

Abstract

Introduction: Spinal tuberculosis (TB) is a serious form of extrapulmonary TB which if left untreated can be fatal due to vertebral body collapse causing cord compression, neurological deficit, and visceral complications. It is mainly treated by antitubercular therapy and bracing. If required, debridement and fixation is also done. With the advent of magnetic resonance imaging and other diagnostics, spinal TB can be detected early. With early diagnosis, we want to assess the outcome of conservative management of spinal TB in the population of Bihar. Materials and Methods: After ethical clearance, a prospective study on 60 patients with spinal TB was conducted. The diagnosis was based on clinical signs and symptoms, serological tests, radiological tests, and histological confirmation. Antitubercular therapy was started and regular assessment was done clinically, serologically, and radiologically. Based on all three parameters, the therapy was stopped once the patient had healed TB. Results: Twenty-eight patients out of 60 had a neurological deficit, and after treatment, 20 patients completely recovered. Kyphosis was seen in 5 patients at presentation and 13 patients after completion of therapy. Two patients developed scoliosis after therapy completion. None had a neurological deficit. Conclusions: Spinal TB can be effectively treated by anti-TB therapy which helps in disease extirpation and neurological improvement but does not prevent the development of spinal deformity.

Keywords

• antituberculosis therapy
• conservative management
• spinal tuberculosis