Spinal tuberculosis treatment: An enduring bone of contention

Spinal tuberculosis is the most common form of extrapulmonary tuberculosis. It is of great importance to neurologists because of the potentially devastating complication of paraplegia, which may set in during active disease or the healed phase. Due to the deep-seated nature of the disease, definitiv...

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Bibliographic Details
Published in:Annals of the Indian Academy of Neurology 2020-07, Vol.23 (4), p.441-448
Main Authors: Garg, Divyani, Goyal, Vinay
Format: Article
Language:English
Subjects:
antitubercular therapy
Paraplegia
pott's disease
spinal tuberculosis
Tuberculosis
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Summary:Spinal tuberculosis is the most common form of extrapulmonary tuberculosis. It is of great importance to neurologists because of the potentially devastating complication of paraplegia, which may set in during active disease or the healed phase. Due to the deep-seated nature of the disease, definitive diagnosis is often challenging. There is no clear consensus on the appropriate duration of therapy for spinal tuberculosis, with various guidelines recommending treatment from as short as 6 months to up to 18 months. In this article, we present a critical appraisal of the evidence on the same. In our opinion, the duration of antitubercular therapy needs to be individualized and the decision to terminate therapy should be multifactorial (clinical, radiological, pathological/microbiological where possible) rather than being enmeshed within any particular guideline.
ISSN:0972-2327
1998-3549
DOI:10.4103/0972-2327.289808