Annals of Indian Academy of Neurology
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Year : 2020  |  Volume : 23  |  Issue : 4  |  Page : 441-448

Spinal tuberculosis treatment: An enduring bone of contention

1 Department of Neurology, Lady Hardinge Medical College, New Delhi, India
2 Department of Neurology, Institute of Neurosciences, Medanta, Gurugram, Haryana, India

Correspondence Address:
Vinay Goyal
Institute of Neurosciences, Medanta, Gurugram, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.AIAN_141_20

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Spinal tuberculosis is the most common form of extrapulmonary tuberculosis. It is of great importance to neurologists because of the potentially devastating complication of paraplegia, which may set in during active disease or the healed phase. Due to the deep-seated nature of the disease, definitive diagnosis is often challenging. There is no clear consensus on the appropriate duration of therapy for spinal tuberculosis, with various guidelines recommending treatment from as short as 6 months to up to 18 months. In this article, we present a critical appraisal of the evidence on the same. In our opinion, the duration of antitubercular therapy needs to be individualized and the decision to terminate therapy should be multifactorial (clinical, radiological, pathological/microbiological where possible) rather than being enmeshed within any particular guideline.

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