A new classification and guide for surgical treatment of spinal tuberculosis

Abstract

So far, there is no widely accepted classification system based on objective findings that can serve as a guide in selecting the treatment method for spinal tuberculosis. This retrospective study evaluates patients with spinal tuberculosis (Pott's disease) treated with different surgical procedures. Our aim was to outline a new classification of spinal tuberculosis. A retrospective review of 76 cases (55 male and 25 female patients) of spinal tuberculosis was conducted. Five of the patients were treated medically, and the others who were treated surgically were classified into three types

Late-onset post-diskectomy tuberculosis at the same operated lumbar level: case report and review of literature

“…Some authors believe that MRI and CT help in the diagnosis of TB spondylitis [10,40]. Although these have facilitated diagnosis to a great extent [6,28], biopsy is the preferred diagnostic modality [28]. MRI is the best imaging method [2,24], and shows typical diskitis, as well as epidural and paraspinal abscesses, better than any other method [24].…”

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

“…We agree that medical therapy is the mainstay of treatment and surgery is called for only in specific conditions. The Gulhane Askeri Tip Akademisi [GATA] classification [1] mentioned by the authors gives some guidelines regarding patient and surgical management. This is similar to the ''middle path regimen'' described by Tuli [2] and followed by us.…”

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

“…Spinal tuberculosis is the most common form of tuberculosis lesion [1,6,8]. 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. However, with proper indications, surgical procedures are considered superior regarding the prevention of neurological deterioration, maintenance of stability, and early recovery [2,[4][5][6][7][8].…”

“…In 2008, Oguz et al [6] et al emphasized that if there is a cold abscess (an abscess that lacks the severe inflammation that usually accompanies infection), only antibiotic-analgesic therapy could not prevent the extensive destruction of vertebral bone and disc material. We believe that this classification system can be considered as a practical guide for spinal tuberculosis treatment planning in all countries.…”