Cochrane Summaries

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Not enough evidence on the routine use of surgery in addition to drug treatment for people with tuberculosis of the spine

Jutte PC, van Loenhout-Rooyackers JH
Published Online: 
31 May 2013

Spinal tuberculosis (spinal TB) occurs in about 1% to 2% of people with TB (the most common infectious disease in the world). The disease can have a major impact on people's lives. Nerves can be squeezed causing pain, loss of feeling, and breathing problems. It can cause bone loss and curvature of the spine, which can lead to loss of nerve function and paralysis after some years, even if the TB has been cured. Correcting with surgery at this point can be difficult because of the complexity of the surgery required. It has been suggested that surgery might be undertaken at the time the TB of the spine is diagnosed and drug treatment (chemotherapy) is being used. However, all surgery has potential adverse effects. This review of trials found there were insufficient numbers of participants in the two trials located (331 participants) to be able to say if routine surgery early on was of overall benefit. Further trials are needed and such trials should assess the pain that people suffer and their views of the disease and treatment.