Conservative Treatment of Tuberculosis of the Lumbar and Lumbosacral Spine

The results of simultaneous posterior–anterior–posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis

“…Conservative treatment includes medical therapy as well as external supports such as bed rest and/or full body plaster immobilization or body braces. Conservative management is indicated for mild to moderate form of the disease if there is no marked abscess formation, spinal deformity and collapse or neural and vertebral instability [20,21,30]. Conservative treatment has been shown to be successful in various reports, despite the evidence of progressive kyphosis, neurological deficit and union delay [32].…”

“…They concluded that best results are achieved in the group treated with anterior resection, debridement and fusion using autogenous bone grafts (Hong Kong procedure) [20,30]. Anterior debridement and arthrodesis allow reaching the focal point of the disease directly, effective debridement of the focal point, rapid bony union with the grafts and prevent progressive collapse and kyphosis [12,20,21,30,32]. However, it has been reported that such successful outcomes are not observed regarding progressive collapse and kyphosis, particularly in the case of two or more levels of involvement, risks of graft insufficiency and increased kyphotic deformity [1,3,9,11,15,23,25].…”

“…The aims of treatment are to eradicate the disease and also to prevent the development of paraplegia and kyphotic deformity and if exists, to manage the pathological picture [9,11,20,23]. Active disease can be eradicated by efficient chemotherapy [20,21,30,32]. However, chemotherapy alone or long periods of bed rest or external supports combined with chemotherapy may not be effective in the prevention of paraplegia and kyphosis [20,22,26].…”

Spinal tuberculosis with concomitant spondylolisthesis: coexisting entities or ‘cause and effect’?

“…6 Several large series have focused on tubercular lesion of the lumbosacral region (Bhojraj et al, 66 cases; Moon et al, 56 cases; Rajasekaran et al, 53 cases; Pun et al, 26 cases). [5][6][7][8] However, none of them have reported any case of spondylolisthesis either secondary to or coexisting with tuberculosis in the same patient. Pathological spondylolisthesis secondary to tuberculosis, or coexisting spondylolisthesis and spinal tuberculosis is an extremely rare occurrence.…”

Letter to the Editor: Minimally Invasive Surgical Approaches in the Management of Tuberculosis of the Thoracic and Lumbar Spine

“…Triple-drug antituberculous chemotherapy can play a main role in treating tuberculosis [5] if the lesion is without complications and limited to the vertebrae. Previously published studies [2,7] have reported worsening of existing symptoms or the appearance of new lesions in patients who initially responded well to antituberculous therapy.…”