Treatment of spinal tuberculosis: Role of surgical intervention

The treatment of tuberculosis of the spine (Pott's disease) is essentially conservative and a vast majority of patients can be successfully managed on antituberculo us therapy (ATT) alone.1 Surgery is indicated in a few specific cases where deformity of spine, pain, or neurological compromise is becoming a serious issue. In cases where surgery is indicated the benefits are almost immediate and excellent. Tuberculosis (TB) is one of the leading causes of infectious disease-related deaths in under-developed countries and it has had a resurgence in developed countries as well. The most common site of bony dissemination of this disease is in the spine. It may be present in about 1% of TB cases.2 , 3 Those who present with spinal TB may have pulmonary TB in one-third to two- thirds of cases.4 , 5 T he most important route of dissemination of TB to the spine is hematogenous.6 Spinal TB usually develops insidiously, and there is thus a gap of several months between onset of symptoms and appropriate medical attention