A modern approach to the diagnosis of tuberculous spondylitis (literature review)

Abstract

Objective — provide a systematic analysis of the scientific literature on the current state of diagnosis of patients with tuberculous spondylitis (TS), and identify prospects for improving the diagnosis of this disease. Materials and methods. To carry out this work, we analyzed 118 literature sources from the Pub Med database on the records of Diagnosis of extrapulmonary tuberculosis. Diagnosis of tuberculous spondylitis, and 26 of them tacked for detailed study. Results and discussion. It was found that TS is the most severe clinical form of osteoarticular tuberculosis (OATB), which is a serious medical and social problem. The percentage of diagnostic errors in TS is very high and its level in recent decades has a clear tendency to increase. The diagnostic pause in this disease usually lasts at least three months. Clinico-radiological examinations are the most accessible and widely used in the world, being the basis for the diagnosis of OATB. From the standpoint of evidence-based medicine, a verified (proven) diagnosis of OATB should be based on data from bacteriological and histological examination of pathological material. Quite often the course of the TS is accompanied by the phenomena of pathomorphosis, which significantly complicates the differential diagnosis. In scientific publications, insufficient attention is paid to the issue of etiological diagnosis of the disease, but traditional methods of clinical and radiological studies have a significant percentage of diagnostic errors. Conclusions. Diagnosis of TS in modern conditions in the vast majority of cases occurs at a later stage (in the advanced form), which causes significant difficulties in the treatment this category of patients.It is important to improve the methods of etiological diagnosis of TS with the following studies sensitivity of the pathogen to antibacterial drugs, which is one of the main conditions for successful treatment.