Results of treatment of spinal tuberculosis by "middle-path" regime

The efficacy of modern drugs in the treatment of tuberculosis of the spine has been evaluated by a personal follow-up for three to ten years. Operation on the vertebral lesion was done only for those patients with or without neural complications who failed to respond favourably to drug therapy and rest. Thus absolute indications for operation were present in only 6 per cent of cases without neural involvement and in 60 per cent of patients with neural deficit. Of patients who responded to drug therapy alone, only 19 per cent revealed increase of kyphosis by more than 10 degrees. The diseased area showed radiological evidence of osseous replacement of 29-6 per cent of cases, of fibro-osseous union in 50 per cent and of fibrous replacement in 20-2 per cent. The overall results of this regime compare favourably with those of radical operation. It is suggested that treatment should in the first place be by modern antitubercular drugs.