Sequential Dramatic Regrowth of a Lumbar Pedicle Post–Antitubercular Therapy

• Main Authors: Saurabh Kumar Verma, Giriraj Singh, Neeraj Basantani, Amit Narang
• Format: Article
• Language: English
• Published: Thieme Medical Publishers, Inc. 2016-06-01
• Series: Indian Journal of Neurosurgery
• Subjects: lumbar pedicle; tuberculosis; antitubercular therapy
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0036-1581975

Abstract Spinal tuberculosis is a frequently encountered extrapulmonary form of the disease. Despite this disease being rampant in developing countries, there are no straightforward guidelines for the diagnosis and treatment of spinal tuberculosis. Surgical intervention is deemed necessary in advanced cases with marked bony involvement or when the spine is considered potentially unstable. However, with the modernization of spinal instrumentation, the general trend among spine surgeons is to fix even a potentially unstable spine. The dilemma still remains whether such cases should be managed surgically or they can be successfully treated using more accurate diagnostic methods and antitubercular therapy (ATT). Here we report the case of a young man with lumbar pedicle tuberculosis who was successfully diagnosed and managed with percutaneous biopsy and ATT vis-à-vis open surgery and fixation. Dramatic resolution of the disease process over a period of 12 months on ATT in this case has been highlighted, thus avoiding fixation in a potentially unstable spine.