Document Detail


Tuberculosis of the spine: a historical review.
MedLine Citation:
PMID:  17483734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Almost all ancient civilizations described tuberculous bacilli in their old scripts, and these bacteria have been found in prehistoric skeletal remains. The clinical availability of specific antitubercular drugs was the most important breakthrough in managing spinal tuberculosis. Any attempt at surgical excision of the disease prior to the antitubercular era met with serious complications, dissemination of disease and high mortality (nearly 50%). Antitubercular drugs markedly improved the results of management by operative treatment. Excellent healing of disease was also observed in those patients who were treated nonoperatively. However, it took many years (1950-1970) for clinicians to appreciate the efficacy of antitubercular drugs. Operations for spinal tuberculosis are now indicated less for control of disease (5-10% of all cases) than for complications, including nonresponding neural deficit (nearly 40% of neural complications), prevention or correction of severe kyphotic deformity, and for tissue diagnosis (approximately 5% of all cases). For a classic spondylodiscitis when surgery is required for débridement and decompression, an anterior approach through an extrapleural anterolateral route or through transpleural route is recommended. Healthy posterior elements should not be jeopardized by surgery. The real control of tuberculous disease requires a serious and sustained global effort to eliminate immunocompromised states, poverty, malnutrition, and overcrowding.
Authors:
S M Tuli
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Publication Detail:
Type:  Historical Article; Journal Article; Review    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  460     ISSN:  0009-921X     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2008-02-12     Completed Date:  2008-03-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29-38     Citation Subset:  AIM; IM    
Affiliation:
VIMHANS Hospital, Institutional Area, New Delhi, India. smohantuli@yahoo.co.in
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MeSH Terms
Descriptor/Qualifier:
Antitubercular Agents / history
History, 18th Century
History, 19th Century
History, 20th Century
History, Ancient
Humans
Prevalence
Tuberculosis, Spinal / epidemiology,  history*,  therapy
Chemical
Reg. No./Substance:
0/Antitubercular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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