title: Management of spinal tuberculosis - a metropolitan city based survey among orthopaedic and neurosurgeons.
abstract: OBJECTIVE
  To explore the core understanding of spinal tuberculosis and its current management plans by orthopaedics and neurosurgeons.
  
  
  METHODS
  The questionnaire-based study was conducted from July 2011 to November 2012 in Karachi and comprised consultant orthopaedics and neurosurgeons belonging to 4 private and 3 government tertiary care teaching hospitals and having a minimum five years of post-fellowship experience. A pre-designed questionnaire was used to explore the current practice in spinal tuberculosis regarding its clinical presentation, diagnosis and treatment. SPSS 15 was used for statistical analysis.
  
  
  RESULTS
  There were 48 subjects in the study; 24(50%) orthopaedic surgeons and 24(50%) neurosurgeons. According to 44(91.70%) respondents, common age for spinal tuberculosis was second and third decades of life, and 37(77.08%)reported refractory back pain with or without neurological deficits as the commonest clinical finding. Typical magnetic resonance imaging findings was the uniform observation of all the 48(100%) respondents. Diagnosis was made by histopathological findings by 39(81.25%) respondents. Anti-tuberculosis therapy was started empirically on the basis of clinical, laboratory and radiological findings by 33(68.75%) respondents. Those in favour of giving anti-tuberculosis therapy for 18 months were 32(66.7%) respondents, and 33(68.75%) thought surgery does not expedite recovery.
  
  
  CONCLUSIONS
  Extremely variable tools of diagnosis and diversified approaches for the treatment are alarming signs for the possible development of resistant strains and complications of spinal tuberculosis.
authors.affiliation: Department of Neurosurgery, Ziauddin University Hospital, Karachi.
authors.forename: Tariq
authors.initials: T
authors.lastname: Muhammad
authors.affiliation: Department of Orthopedic Surgery, Ziauddin University Hospital, Karachi.
authors.forename: Nadeem Akbar
authors.initials: NA
authors.lastname: Baloch
authors.affiliation: House Officer, Ziauddin University Hospital, Karachi.
authors.forename: Asif
authors.initials: A
authors.lastname: Khan
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D009493:Neurosurgery; D009985:Orthopedics; D010154:Pakistan; D011795:Surveys and Questionnaires; D014399:Tuberculosis, Spinal / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
chemical_list: D000995:Antitubercular Agents
keywords: Tuberculosis, Spine, Anti-tuberculosis therapy.