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Pathophysiology and Treatment of Spinal Tuberculosis

Spinal tuberculosis constitutes >50% of cases of skeletal tuberculosis1. Although the disease still predominantly afflicts the underprivileged population in developing countries, it has been increasingly reported in economically developed countries worldwide2. The increased incidence of human immunodeficiency virus (HIV), immunodeficiency due to diabetes, chemotherapy for the treatment of cancer, old age, and a steady increase in global travel and immigration have all helped to maintain tuberculosis as a global disease2,3.

In recent years, the clinical and radiographic features of spinal tuberculosis have changed considerably. Atypical presentations are more common, making clinical suspicion and histopathological confirmation essential4.

Powerful anti-tubercular therapy is usually sufficient for the treatment of uncomplicated spinal tuberculosis, and operative intervention is advised only for specific indications to prevent and treat complications5. …