Clinical and radiological outcomes after conservative treatment of TB spondylitis: is the 15 years' follow-up in the MRC study long enough?

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
W Y Cheung, Keith D K Luk

Abstract

Tuberculosis of the spine is a still a common disease entity, not only in developing countries but is also returning in developed countries especially in the immune-compromised patients. Conservative treatment with chemotherapy is still the main stay of treatment. This article focuses on the clinical and radiological outcomes, and problems with conservative treatment. The available literature of anti-tuberculosis chemotherapy in managing spinal tuberculosis was reviewed. Data sources included relevant literature of the English language identified through Medline search from 1946 to 2011. Personal experience and unpublished reviews from the authors' institution were also included. Although majority of patients respond well to anti-tuberculosis chemotherapy, about 15 % of them develop paradoxical response. The Medical Research Council (MRC) studies have shown that for patients without significant neurological deficits, operative and conservative treatment could produce the same clinical outcome at 15 years follow-up. Patients treated operatively with debridement and spinal fusion with strut graft had faster bony fusion and less kyphotic deformity. In contrast, those treated with drugs alone or with simple debridement without fusi...Continue Reading

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Citations

Oct 12, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ferran Pellisé
Apr 23, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·S R ManoharanN A Quraishi
Jan 5, 2014·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Robert C Mulholland
Feb 20, 2014·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yann Philippe CharlesJean-Paul Steib
Aug 1, 2014·Clinical Neurology and Neurosurgery·Ming-xiang ZouYou-wen Deng
Jul 6, 2014·Internal Medicine·Ryutaro Tanizaki, Jin Takasaki
Feb 28, 2015·The Spine Journal : Official Journal of the North American Spine Society·Ming-Xiang ZouYou-Wen Deng
May 15, 2016·Journal of Orthopaedic Surgery and Research·Zehua ZhangJianzhong Xu
Mar 13, 2014·Orthopaedics & Traumatology, Surgery & Research : OTSR·S VaratharajahJ-P Steib
Mar 7, 2014·The American Journal of Tropical Medicine and Hygiene·Hasan S Merali, Heng Sing
Nov 27, 2015·Journal of Experimental Neuroscience·Safak EkinciOmer Ersen
May 20, 2015·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Kee-Yong Ha, Young-Hoon Kim
Jun 19, 2021·Annals of Medicine and Surgery·Mohammad Noah Hasan KhanMuhammad Umer Rasool
Jul 13, 2021·British Journal of Neurosurgery·Anan ShtayaAli Nader-Sepahi

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Methods Mentioned

BETA
biopsy
biopsies
dissection

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