Prospective study comparing the clinical outcomes of conservative and surgically treated spinal tuberculosis

Abstract

Introduction: Spinal tuberculosis is a serious form of extra pulmonary tuberculosis which if left untreated can be fatal; neurologic dysfunctions in association with active tuberculosis of spine can be prevented by early diagnosis and prompt treatment. Prompt treatment can reverse paralysis and minimize the potential disability resulting from Pott’s paraplegia. A significant dilemma exists as to which line of management a patient needs to be subjected once diagnosed to have spinal tuberculosis. Objective: Assess the functional and neurological outcome of patients treated with different modalities of treatment and attempts to ascertain the best practise for effective management of a case of spinal tuberculosis. Materials and Methods: 22 adult patients diagnosed with spinal TB and treated with either conservative line of management or CT/USG guided pigtail catheter drainage with chemotherapy or surgery combined with chemotherapy, were considered. Patients were followed up until completion of anti-TB treatment. Clinical outcomes were assessed using Visual analogue scale, Oswestry Disability Index and modified McCormick grade. Results: Patients having milder form were treated conservatively using anti-tubercular drugs alone (n=13). Patients with well-established abscess and without instability were treated using CT/USG guided pigtail catheter drainage along with antitubercular drugs (n=6).