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Spinal tuberculosis with neurological deficits

C Vidyasagar1, H K Murthy

  • 1Department of Neurosurgery, Sanjay Gandhi Accident and Rehabilitation Centre, Bangalore, Karnataka.

The National Medical Journal of India
|January 1, 1996
PubMed
Summary
This summary is machine-generated.

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Tuberculosis (TB) of the spine with neurological complications requires surgical decompression and chemotherapy. Outcomes depend on deficit severity, with lumbar spine TB showing better recovery than thoracic spine TB.

Area of Science:

  • Neurosurgery
  • Infectious Diseases
  • Spinal Surgery

Background:

  • Tuberculosis of the spine (TB spine) can lead to severe neurological deficits.
  • Accurate diagnosis and effective treatment are crucial for managing spinal TB complications.

Purpose of the Study:

  • To review outcomes of surgical decompression and chemotherapy for spinal tuberculosis with neurological deficits.
  • To evaluate the effectiveness of different diagnostic methods and surgical approaches.

Main Methods:

  • Review of 200 patients with spinal TB and neurological complications, graded using the Frankel system.
  • Investigations included neurological assessment, radiography, contrast myelography, and spinal CT scans.
  • Treatment involved surgical decompression, chemotherapy, and immobilization.

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Main Results:

  • Contrast myelography was deemed the best indicator of spinal compression.
  • Unexpected intraoperative findings included various neoplastic and infectious conditions.
  • Only 30 patients showed partial recovery; outcomes correlated with the Frankel grade and lesion location (lumbar better than thoracic).
  • Mortality was associated with extensive systemic TB.

Conclusions:

  • A combination of surgery and chemotherapy is recommended for spinal TB with neurological deficits.
  • Surgical decompression aims to relieve cord compression, followed by internal splintage.
  • Conservative treatment is not advised due to diagnostic challenges distinguishing TB from neoplastic lesions.