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European Spine Journal

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01-12-2017 | Original Article

Is decompressive surgery the only treatment option? A case series of patients with spinal tuberculosis in advanced pregnancy

Authors: Ashok K. Rathod, Vishwajeet Singh, Prateek Patil, Hemant Singh

Published in: European Spine Journal | Issue 12/2017

Abstract

Purpose

To present cases of spinal tuberculosis in advanced pregnancy treated on anti-tuberculous drug regimen with successful outcome and proposing alternative paradigm to surgical decompression. A case series of five patients in stages of advanced pregnancy with neurologic deterioration and spinal tuberculosis were reported and treated.

Methods

Five patients with backache in advanced stages of pregnancy were reported. Patients were diagnosed as cases of spinal tuberculosis on further imaging studies. Patients were treated and followed up till complete clinical and radiological recovery.

Results

Four out of five patients were treated conservatively on ATT and rest. One patient underwent decompression without instrumentation. All patients recovered neurologically. There were foetal complications in two cases with foetal demise. One patient who underwent surgical decompression had preterm labour with still birth, apparently due to adverse reactions with anaesthetic drugs.

Conclusion

Spinal tuberculosis in pregnancy is a rare occurrence. Hesitation in performing radiographs complicates the outcome with delay in diagnosis and neurological compromise. There are no clear guidelines for treatment of such cases. Conservative treatment with ATT in pregnant patients may be a viable approach. Neurological compromise does not mandate surgical decompression, which in itself is not devoid of complications. Concern of foetal complications is high in surgical treatment.

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Title: Is decompressive surgery the only treatment option? A case series of patients with spinal tuberculosis in advanced pregnancy
Authors: Ashok K. Rathod
Vishwajeet Singh
Prateek Patil
Hemant Singh
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 12/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-5143-2

At a glance: The STEP trials

Springer Medicine

Is decompressive surgery the only treatment option? A case series of patients with spinal tuberculosis in advanced pregnancy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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