Commentary: One-year multidrug treatment for tuberculosis of the cervical spine in children.

Abstract

likely to cause deformity, neurological deficit, and growth alteration in children than in adults,1 owing to a lack of restraint, greater mobility, and cartilaginous open physeal plates at both ends of the vertebra in the paediatric cervical spine.2 In this issue, Agarwal et al.3 report the short-term outcome in 22 children (mean age, 9.1 years) after one-year antitubercular multidrug treatment for tuberculosis of the cervical spine. The study shows excellent clinical outcome with chemotherapy alone in 86% of patients and reversal of neurological impairment in all 3 affected patients. This finding is consistent with a Cochrane Database Systemic Review,4 guidelines of the Royal College of Physicians5 (which demonstrated no additional benefit of surgical debridement or resection of the spinal focus and bone grafting on top of chemotherapy, compared with chemotherapy alone), and a report from the Medical Research Council Working Party on Tuberculosis of the Spine6 (which showed 24 of 30 patients in one study and 74 of 85 patients in another in Korea had complete resolution of myelopathy and function after medical treatment). Agarwal et al.3 reported that the only obvious complications were kyphosis (n=2), kyphoscoliosis (n=1), and scoliosis (n=1) attributed to contiguous multilevel involvement at the mid-cervical or cervicodorsal region. The period of immobilisation Commentary: One-year multidrug treatment for tuberculosis of the cervical spine in children