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The Medical Management of Spinal Tuberculosis

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Tuberculosis of the Spine

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Abstract

Anti-tubercular drugs have revolutionized the treatment of tuberculosis and have significantly reduced the mortality rates making them the mainstay in the management of uncomplicated spinal tuberculosis. The unique features of Mycobacterium tuberculosis, use of multiple drugs, development of drug resistance, and prolonged duration of treatment make anti-tubercular therapy challenging. The first-line drugs are the most potent, least toxic, and cheaper drugs in comparison to the second-line drugs. Side effects are common; therefore, a thorough knowledge of the pharmacological properties of drugs is essential. The current guidelines recommend daily dosing of fixed drug combinations. Though 9 to 12 months of therapy have been proven to be effective, there is still no consensus on treatment duration yet. In the light of emerging drug resistance, the second-line drugs are used frequently, and there is an unmet need for newer drugs with better safety profiles. Immunomodulators have the potential to be a valuable adjuvant to anti-tubercular drugs in increasing cure rates, decreasing the duration of therapy, and thereby decreasing drug resistance. Increased drug-sensitivity testing and ensuring compliance to anti-tubercular therapy is the key in mitigating the pandemic of tuberculosis and is fundamental to WHO’s “End TB” strategy.

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  1. Department of Spine Surgery, Ganga Hospital, Coimbatore, India

    K. S. Sri Vijay Anand & Rishi M. Kanna

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  1. K. S. Sri Vijay Anand
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  1. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India

    Sarvdeep Singh Dhatt

  2. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India

    Vishal Kumar

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Sri Vijay Anand, K.S., Kanna, R.M. (2022). The Medical Management of Spinal Tuberculosis. In: Dhatt, S.S., Kumar, V. (eds) Tuberculosis of the Spine. Springer, Singapore. https://doi.org/10.1007/978-981-16-9495-0_13

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