Annals of Indian Academy of Neurology
  Users Online: 3878 Home | About the Journal | InstructionsCurrent Issue | Back IssuesLogin      Print this page Email this page  Small font size Default font size Increase font size
 
AIAN REVIEW
Ahead of Print

Tuberculosis of the spinal cord


1 Department of Neurology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
2 Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Infectious Diseases, PD Hinduja Hospital and MRC, Mumbai, Maharashtra, India
4 Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India
5 Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
6 Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Abi Manesh,
Department of Infectious Diseases, Infectious Diseases Research and Training Centre (IDTRC), Christian Medical College, Vellore - 632 004, Tamil Nadu
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.aian_578_22

Tuberculosis involving the spinal cord is associated with high mortality and disabling long-term sequelae. Although tuberculous radiculomyelitis is the most frequent complication, pleomorphic clinical manifestations exist. Diagnosis can be challenging among patients with isolated spinal cord tuberculosis due to diverse clinical and radiological presentations. The principles of management of tuberculosis of the spinal cord are primarily derived from, and dependent upon, trials on tuberculous meningitis (TBM). Although facilitating mycobacterial killing and controlling host inflammatory response within the nervous system remain the primary objectives, several unique features require attention. The paradoxical worsening is more frequent, often with devastating outcomes. The role of anti-inflammatory agents such as steroids in adhesive tuberculous radiculomyelitis remains unclear. Surgical interventions may benefit a small proportion of patients with spinal cord tuberculosis. Currently, the evidence base in the management of spinal cord tuberculosis is limited to uncontrolled small-scale data. Despite the gargantuan burden of tuberculosis, particularly in lower and middle-income countries, large-scale cohesive data are surprisingly sparse. In this review, we highlight the varied clinical and radiological presentations, performance of various diagnostic modalities, summarize data on the efficacy of treatment options, and propose a way forward to improve outcomes in these patients.


Print this article
 [NEXT]
 [PREV]
 Table of Contents

  Search Pubmed for
 
    -  Garg D
    -  Radhakrishnan DM
    -  Agrawal U
    -  Vanjare HA
    -  Gandham EJ
    -  Manesh A
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed171    
    PDF Downloaded12    

Recommend this journal