Modern management of spinal tuberculosis

Area of Science:

• Orthopedics
• Infectious Diseases
• Neurosurgery

Background:

• The incidence of spinal tuberculosis (Pott's disease) is rising alongside pulmonary tuberculosis.
• Drug-resistant strains, immunocompromised hosts, and advanced imaging present management challenges.
• Recent literature on modern Pott's disease management in developed nations is limited.

Purpose of the Study:

• To review the authors' experience in managing Pott's disease over five years.
• To evaluate the effectiveness of current treatment strategies, including surgical interventions.
• To identify factors influencing patient outcomes.

Main Methods:

• Retrospective study of 20 patients diagnosed with Pott's disease.
• Analysis of patient demographics, clinical presentation, diagnostic methods, and treatment approaches.
• Review of surgical procedures performed, including vertebrectomy, laminectomy, and instrumentation.

Main Results:

• The study included 20 patients (mean age 49, 80% male) with varied spinal involvement (thoracic most common).
• Common symptoms included spinal pain, weakness, and paraspinal mass; 13 patients had spinal epidural compression.
• Eleven patients underwent surgery; those treated early with instrumentation showed improved neurological function and reduced spinal deformity (average angulation decreased from 31 to 24 degrees).

Conclusions:

• Selected patients benefit from early operative treatment, including instrumentation, for Pott's disease.
• Surgical intervention can minimize neurological deterioration and spinal deformity.
• Effective management leads to improved neurological outcomes and allows for early ambulation.