Medical management of spinal tuberculosis: an experience from Pakistan.
METHODS
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.


BACKGROUND
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 88.27% patients. Eighty-five percent of cases completely improved on medical treatment without any surgical intervention.


CONCLUSIONS
Uncomplicated spinal tuberculosis is a medical problem. The study shows that surgical intervention is not always necessary.
Bakhsh
Ahmed
A
Saad Specialist hospital, Al-Khobar 31952, Kingdom of Saudi Arabia. ahmedbakhsh@gmail.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use*; D002648:Child; D002985:Clinical Protocols / Q000592:standards; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010154:Pakistan / Q000453:epidemiology; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D014399:Tuberculosis, Spinal / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
D000904:Antibiotics, Antitubercular