Garg Divyani, Goyal Vinay
Department of Neurology, Lady Hardinge Medical College, New Delhi, India.
Department of Neurology, Institute of Neurosciences, Medanta, Gurugram, Haryana, India.
Ann Indian Acad Neurol. 2020 Jul-Aug;23(4):441-448. doi: 10.4103/aian.AIAN_141_20. Epub 2020 Jul 16.
Spinal tuberculosis is the most common form of extrapulmonary tuberculosis. It is of great importance to neurologists because of the potentially devastating complication of paraplegia, which may set in during active disease or the healed phase. Due to the deep-seated nature of the disease, definitive diagnosis is often challenging. There is no clear consensus on the appropriate duration of therapy for spinal tuberculosis, with various guidelines recommending treatment from as short as 6 months to up to 18 months. In this article, we present a critical appraisal of the evidence on the same. In our opinion, the duration of antitubercular therapy needs to be individualized and the decision to terminate therapy should be multifactorial (clinical, radiological, pathological/microbiological where possible) rather than being enmeshed within any particular guideline.
脊柱结核是肺外结核最常见的形式。由于截瘫这一潜在的毁灭性并发症可能在疾病活动期或愈合期出现，因此对神经科医生来说非常重要。由于该疾病位置较深，明确诊断往往具有挑战性。对于脊柱结核的适当治疗疗程尚无明确共识，各种指南推荐的治疗时间从短至6个月到长达18个月不等。在本文中，我们对相关证据进行了批判性评估。我们认为，抗结核治疗的疗程需要个体化，终止治疗的决定应基于多方面因素（临床、放射学、尽可能包括病理学/微生物学因素），而不应局限于任何特定的指南。
