Tariq Muhammad, Nadeem Akbar Baloch, Asif Khan.
Management of spinal tuberculosis - a metropolitan city based survey among orthopaedic and neurosurgeons.
J Pak Med Assoc Jan ;65(12):1256-60.

Objective: To explore the core understanding of spinal tuberculosis and its current management plans by orthopaedics and neurosurgeons. Methods: The questionnaire-based study was conducted from July 2011 to November 2012 in Karachi and comprised consultant orthopaedics and neurosurgeons belonging to 4 private and 3 government tertiary care teaching hospitals and having a minimum five years of post-fellowship experience. A pre-designed questionnaire was used to explore the current practice in spinal tuberculosis regarding its clinical presentation, diagnosis and treatment. SPSS 15 was used for statistical analysis. Results: There were 48 subjects in the study; 24(50%) orthopaedic surgeons and 24(50%) neurosurgeons. According to 44(91.70%) respondents, common age for spinal tuberculosis was second and third decades of life, and 37(77.08%)reported refractory back pain with or without neurological deficits as the commonest clinical finding. Typical magnetic resonance imaging findings was the uniform observation of all the 48(100%) respondents. Diagnosis was made by histopathological findings by 39(81.25%) respondents. Anti-tuberculosis therapy was started empirically on the basis of clinical, laboratory and radiological findings by 33(68.75%) respondents. Those in favour of giving anti-tuberculosis therapy for 18 months were 32(66.7%) respondents, and 33(68.75%) thought surgery does not expedite recovery. Conclusion: Extremely variable tools of diagnosis and diversified approaches for the treatment are alarming signs for the possible development of resistant strains and complications of spinal tuberculosis.

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