Spinal tuberculosis may be treated surgically or with drugs
According to data from a recently published case study, treatment for latent or active tuberculosis of the spine can be surgical or drug-related, depending on the patient and his or her comorbidities.
Tuberculosis, though most commonly found in the lungs, can affect any organ system and occurs skeletally in about 1% to 3% of patients; however, more than half of these patients do not have concurrent active pulmonary tuberculosis. Researchers presented a case study of a 25-year-old incarcerated inmate who presented with cervical and occipitocervical junction tuberculosis.
Prisons are high-risk settings for tuberculosis exposure, with latent tuberculosis incidents being 23-times higher and active tuberculosis being 26.4-times higher, according to the researchers.
MRI is the best screening tool to identify tuberculosis of the spine and can be used to identify complications stemming from tuberculosis, as well, such as myositis, bursitis, cellulitis and sinus tract formation.
Isoniazid (Sandoz), Rifadin (rifampin, Sanofi Aventis), Myambutol (ethambutol hydrochloride, STI Pharma) and pyrazinamide are used to treat active spinal tuberculosis, including the patient discussed in the present case study.
In addition to medication therapy, however, the 25-year-old inmate also underwent occipitocervical fusion with the VuePoint OCT posterior occipitocervical fixation system (NuVasive), C2 pars interarticularis screws and C3-4 lateral mass screws.
According to the researchers, the patient had an uneventful postoperative recovery, and the department of corrections performed the follow-up care. – by Robert Linnehan
Disclosures: Macke reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.