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Updated: Jul 15, 2025
03:47
A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024
264
Delphi-Based Survey for Surgical Indications in Biopsy Proven Active Adult Spinal Tuberculosis
K Venugopal Menon1, Saumyajit Basu2, Gauri Oka3
1Department of Orthopedics, Bharati Vidyapeeth Medical College Hospital, Pune, India.
Global Spine Journal
|September 30, 2023
Summary
This Delphi survey established expert consensus on surgical dilemmas in adult spinal tuberculosis (TB). Key findings clarify when surgery is indicated, emphasizing neurological deficits over other factors for spinal TB treatment.
Area of Science:
- Orthopedics
- Neurosurgery
- Infectious Diseases
Background:
- Spinal tuberculosis (TB) presents complex treatment challenges, particularly regarding surgical intervention in adult patients.
- Existing guidelines offer limited consensus on critical decision-making points for surgical management.
Purpose of the Study:
- To achieve expert consensus on dilemmas in surgical treatment for adult spinal TB.
- To provide evidence-based recommendations for clinical practice.
Main Methods:
- A multi-stage Delphi survey involving Key Opinion Leaders (KOLs) in spine surgery.
- Literature review, question development, and three rounds of expert surveys with a 70% consensus threshold.
Main Results:
- Consensus was reached on 22 questions regarding surgical indications and management.
- Absolute surgical indications include neurological deficit progression during anti-tubercular chemotherapy (ATT).
- Epidural abscess decompression is recommended only with concurrent neurological deficits; pain alone is not an indication.
Conclusions:
- This study represents the first national consensus on surgical treatment for adult spinal TB.
- Recommendations address serological, radiographic, and clinical aspects, guiding surgical decision-making.
- Factors like duration of ATT, active pulmonary TB, or drug-resistant TB were clarified as not primary surgical indications.
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