Management of spinal tuberculosis-a metropolitan city based survey among orthopaedic and neurosurgeons

Objective: to explore the core understanding of spinal tuberculosis and its current management plans by orthopaedics and neurosurgeons. methods: the questionnaire-based study was conducted from july 2011 to november 2012 in karachi and comprised consultant orthopaedics and neurosurgeons belonging to 4 private and 3 government tertiary care teaching hospitals and having a minimum five years of post-fellowship experience. a pre-designed questionnaire was used to explore the current practice in spinal tuberculosis regarding its clinical presentation,diagnosis and treatment. spss 15 was used for statistical analysis. results: there were 48 subjects in the study; 24(50%) orthopaedic surgeons and 24(50%) neurosurgeons. according to 44(91.70%) respondents,common age for spinal tuberculosis was second and third decades of life,and 37(77.08%)reported refractory back pain with or without neurological deficits as the commonest clinical finding. typical magnetic resonance imaging findings was the uniform observation of all the 48(100%) respondents. diagnosis was made by histopathological findings by 39(81.25%) respondents. anti-tuberculosis therapy was started empirically on the basis of clinical,laboratory and radiological findings by 33(68.75%) respondents. those in favour of giving anti-tuberculosis therapy for 18 months were 32(66.7%) respondents,and 33(68.75%) thought surgery does not expedite recovery. conclusion: extremely variable tools of diagnosis and diversified approaches for the treatment are alarming signs for the possible development of resistant strains and complications of spinal tuberculosis. © 2015 pakistan medical association. all rights reserved.