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REVIEW ARTICLE
Year : 2019  |  Volume : 18  |  Issue : 2  |  Page : 35-43

Spinal tuberculosis - Current management approach


1 Department of Orthopaedic and Traumatology, Spine Unit, Faculty of Clinical Sciences, College of Medicine, Ambrose Alli University, Ekpoma; Department of Orthopaedic and Traumatology, Spine Unit, Irrua Specialist Teaching Hospital, Kano, Nigeria
2 Department of Surgery, Ambrose Alli University, Ekpoma, Edo State; Department of Surgery, Irrua Specialist Teaching Hospital, Irrua, Nigeria
3 Department of Clinical Services, Spinal Surgery Unit, National Orthopaedic Hospital, Dala, Kano, Nigeria

Correspondence Address:
Prof. John E Onuminya
Department of Orthopaedics and Traumatology, Spine Unit, Faculty of Clinical Sciences, College of Medicine, Ambrose Alli University, Ekpoma, Edo State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njot.njot_25_19

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Broad narrative review. To review and summarise the current literature on the management of tuberculosis (TB) spine. A thorough review of literature was performed on the epidemiology, aetiology, pathophysiology, pathology, clinical features and management of TB spine. Spinal TB accounts for half of skeletal TB and remains a common cause of public health concern in the developing world. The thoracic spine segment is the most affected. Patient commonly present with back pain and gibbus. The diagnosis involves demonstrating Mycobacterium tuberculosis on microscopy or culture as well as characteristic histology findings. Magnetic resonance imaging is the gold standard imaging modality. Medical therapy with anti-TB agents is the mainstay of treatment. Surgery is supplementary and indicated in selected cases. Spinal TB carries a good prognosis when detected and treated early. Delays can be associated with the development of complications including difficult-to-manage deformities. Multi-drug anti TB chemotherapy remains the bedrock of treatment. Surgery is supplementary and when indicated, takes the form of abscess drainage, debridement and fusion with or without instrumentation.


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