Spinal Tuberculosis

Abstract

Tuberculosis of the spine is a challenging disease to treat because of the prolonged time of conservative treatment and the technical difficulties of surgical intervention. The disease remains an important public health issue in developing countries, but is also returning in developed countries due to immigration and especially in the immune compromised patients. The most common symptom reported is back pain and the most frequent segment involved is the thoracic spine. The early diagnosis and treatment is mandatory in order to avoid neurological complications (Pott’s paraplegia) and grotesque spinal deformity. Medical treatment or combined medical and surgical strategies can control the disease in most patients. Conservative treatment with a combination of anti-TB drugs yields similar long term results when compared to surgery in patients with no neurological deficit or instability. If indicated radical debridement and instrumentation of the involved spine combined with prolonged chemotherapy result in improvement in quality of life of patients, better functional and cosmetic outcomes and closer to normal-like spine.