Results of treatment of spinal tuberculosis by 'middle path' regime

Abstract

The efficacy of modern drugs in the treatment of tuberculosis of the spine was evaluated by a follow up for 3 to 10 yr of 900 cases. Operation on the vertebral lesion was done only for those patients with or without neural complications who failed to respond favourably to drug therapy and rest. Thus absolute indications for operation were present in only 6% of cases without neural involvement and in 60% of patients with neural deficit. Of the patients who responded to drug therapy alone, only 19% revealed increase of kyphosis by more than 10 degrees. The diseases area showed radiological evidence of osseous replacement in 29.6% of cases, of fibro osseous union in 50% and of fibrous replacement in 20.2%. The overall results of this regime compare favourably with those of radical operation. It is suggested diseased treatment should in the first place be by modern antitubercular drugs.