Spinal tuberculosis with neurological deficit

ABSTRACT

A prospective evaluation of various modalities of management of spinal tuberculosis with neurologic deficit is given in this article. Twenty patients suffering from this ailment were managed over a period of three years. All of these were given an initial trial of antituberculou chemotherapy. Ten patients who responded favourably were continued on conservative management. Rest of the ten patients underwent surgery in the form of modified Hong Kong operation [six patients], anterolateral decompression [three patients], and costotransversectomy [one patient], all followed by hyperextension brace. The selection of the type of operation was based on the age, state of health and the extent of the disease. Seven out of the ten patients of conservative management recovered completely while three were lost to follow up. Modified Hong Kong operation showed 67%, anterolateral decompression 33% and costotransversectomy 100% recovery. Three patients, one after modified Hong Kong operation and two after anterolateral decompression died showing 15% mortality. No single method of management suits every patient and a "tailor made" treatment is needed after individual assessment of each case