Rizwan Masood Butt, Muhammad Ali Bokhari, Shahzad Shams.
Spinal Tuberculosis easy to diagnose; difficult to manage.
Professional Med J Jan ;4(4):339-44.

The author reviewed 60 cases of spinal tuberculosis treated from Jan 1993 to Jan 1995 at Lahore General Hospital, Clinical findings included back pain in 47(79%) paraparesis in 40(66%) and Kyphosis in 31(52%) patients, less common features included fever, sensory disturbance and sphincter dysfunctions. Predominant vertebral body involvement was present in 26(43%) and marked bone collapse in 11(18%) patients. Intraspinal granulomatous tissue causing neurological dysfunction in the absence of bone destruction was seen in 33(55%) cases. All 60 patients received antituberculous medications. Laminectomy and debridement of extra granulomatous tissue or abscess drainage was done in 43 (71 %) patients, laminectomy and bracing in 8.3%, biopsy followed by bracing in 11.6% and bracing only in 3.3%. We didn`t perform internal stabilization in any of our patients. An average follow-up time of 6 months course of antituberculous therapy (ATT) shorter than six months were invariably associated with disease recurrence. It is suggested that any young female from poor social background with backache and positive family history of tuberculosis should be examined and investigated fully for tuberculosis spine and managed with appropriately selected treatment modality and compliance of the patient. Satisfactory outcome can be obtained in majority of patients.

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