Spinal Tuberculosis: Comparative Study Between Surgical & Conservative Management
Abstract
Background: Due to globalization, spinal tuberculosis is no longer a disease limited to developing nations and accounts for 50%-60% of osseous TB. Worldwide conservative treatment including anti-tubercular therapy is popular but along with surgical treatment plays a vital role. Methods: This hospital-based comparative study was conducted in a multi-disciplinary hospital for two years. A total of 38 cases were enrolled into the study out of which 22 cases with spinal tuberculosis underwent surgical management and 16 cases were treated conservatively. All patients were treated with standard anti-TB drugs and the addition of add-on therapy by Levofloxacin as per National Antitubercular Therapy Guideline pre- and postoperatively where applicable and were followed regularly after 3 months. Neurological function and pain were evaluated in all cases during admission and post procedure where applicable by ASIA grade scale and visual analogue scale (VAS) respectively. Outcomes were finally assessed 3 months after initiation of treatment. Results: Out of 38 cases, 4 were lost to follow-up. Among the available 34 cases, 18 were men and 16 were women. The mean age was 37.10 (±14.70) years and age range was 18 to 56 years. At 3 months final follow-up, the VAS score significantly improved from 7.97 (±1.27) pre-procedure to 1.23 (±0.69) post procedure (P < 0.001) and all patients became pain less, with final VAS score 0-3. At the 3 months follow-up, the ESR and CRP significantly improved…
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