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Active tuberculosis of spine: Current updates

BACKGROUND: Spinal tuberculosis (TB) is the most common extrapulmonary form of tuberculosis. In both developing and developed countries, TB has been on the rising trend due to factors such as increasing HIV coinfection, multidrug resistance of the organism, and global migration. Spinal TB, which mos...

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Autores principales: Shanmuganathan, Rajasekaran, Ramachandran, Karthik, Shetty, Ajoy Prasad, Kanna, Rishi Mugesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510092/
https://www.ncbi.nlm.nih.gov/pubmed/37736557
http://dx.doi.org/10.1016/j.xnsj.2023.100267
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author Shanmuganathan, Rajasekaran
Ramachandran, Karthik
Shetty, Ajoy Prasad
Kanna, Rishi Mugesh
author_facet Shanmuganathan, Rajasekaran
Ramachandran, Karthik
Shetty, Ajoy Prasad
Kanna, Rishi Mugesh
author_sort Shanmuganathan, Rajasekaran
collection PubMed
description BACKGROUND: Spinal tuberculosis (TB) is the most common extrapulmonary form of tuberculosis. In both developing and developed countries, TB has been on the rising trend due to factors such as increasing HIV coinfection, multidrug resistance of the organism, and global migration. Spinal TB, which most often affects the lower thoracic and thoracolumbar area, accounts for 50% of all musculoskeletal tuberculosis. METHODS: Using the Cochrane Database of Systematic Reviews, EMBASE, and PubMed, a systematic computerized literature search was performed. Analyses of studies published within the past 10 years were conducted. The searches were performed using Medical Subject Headings terms, with “spinal tuberculosis,” “diagnosis,” “epidemiology,” and “etiology”,“management,” “surgery,” and “therapy” as subheadings. RESULTS: Progressive collapse, kyphosis, and neurological deficiency are hallmarks of the disease because of its destructive effect on the intervertebral disc and adjacent vertebral bodies. The condition may be identified using laboratory testing and distinctive imaging features, but the gold standard for diagnosis is tissue diagnosis using cultures, histology, and polymerase chain reaction. Uncomplicated spinal TB is today a medical condition that can be adequately treated by multidrug ambulatory chemotherapy. Surgery is reserved for individuals who have instability, neurological impairment, and deformity correction. Debridement, deformity correction, and stable fusion are the cornerstones of surgical treatment. CONCLUSIONS: Clinical results for the treatment of spinal TB are generally satisfactory when the disease is identified and treated early. However, the major health issue and the biggest obstacle in achieving the goals of the “End TB strategy” is the recent rise in the emergence of drug resistance. Hence strict vigilance and patient perseverance in the completion of the treatment is the main need of the hour.
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spelling pubmed-105100922023-09-21 Active tuberculosis of spine: Current updates Shanmuganathan, Rajasekaran Ramachandran, Karthik Shetty, Ajoy Prasad Kanna, Rishi Mugesh N Am Spine Soc J Spinal Infections BACKGROUND: Spinal tuberculosis (TB) is the most common extrapulmonary form of tuberculosis. In both developing and developed countries, TB has been on the rising trend due to factors such as increasing HIV coinfection, multidrug resistance of the organism, and global migration. Spinal TB, which most often affects the lower thoracic and thoracolumbar area, accounts for 50% of all musculoskeletal tuberculosis. METHODS: Using the Cochrane Database of Systematic Reviews, EMBASE, and PubMed, a systematic computerized literature search was performed. Analyses of studies published within the past 10 years were conducted. The searches were performed using Medical Subject Headings terms, with “spinal tuberculosis,” “diagnosis,” “epidemiology,” and “etiology”,“management,” “surgery,” and “therapy” as subheadings. RESULTS: Progressive collapse, kyphosis, and neurological deficiency are hallmarks of the disease because of its destructive effect on the intervertebral disc and adjacent vertebral bodies. The condition may be identified using laboratory testing and distinctive imaging features, but the gold standard for diagnosis is tissue diagnosis using cultures, histology, and polymerase chain reaction. Uncomplicated spinal TB is today a medical condition that can be adequately treated by multidrug ambulatory chemotherapy. Surgery is reserved for individuals who have instability, neurological impairment, and deformity correction. Debridement, deformity correction, and stable fusion are the cornerstones of surgical treatment. CONCLUSIONS: Clinical results for the treatment of spinal TB are generally satisfactory when the disease is identified and treated early. However, the major health issue and the biggest obstacle in achieving the goals of the “End TB strategy” is the recent rise in the emergence of drug resistance. Hence strict vigilance and patient perseverance in the completion of the treatment is the main need of the hour. Elsevier 2023-08-21 /pmc/articles/PMC10510092/ /pubmed/37736557 http://dx.doi.org/10.1016/j.xnsj.2023.100267 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Spinal Infections
Shanmuganathan, Rajasekaran
Ramachandran, Karthik
Shetty, Ajoy Prasad
Kanna, Rishi Mugesh
Active tuberculosis of spine: Current updates
title Active tuberculosis of spine: Current updates
title_full Active tuberculosis of spine: Current updates
title_fullStr Active tuberculosis of spine: Current updates
title_full_unstemmed Active tuberculosis of spine: Current updates
title_short Active tuberculosis of spine: Current updates
title_sort active tuberculosis of spine: current updates
topic Spinal Infections
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510092/
https://www.ncbi.nlm.nih.gov/pubmed/37736557
http://dx.doi.org/10.1016/j.xnsj.2023.100267
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