Tuberculous vertebral osteomyelitis treatment
Esposito et al., highlighted the importance of suspecting this disorder in children with both aspecific systemic and neurological symptoms, in order to reach a timely diagnosis for appropriate and targeted intervention, avoiding the risk of overtreatment and malpractice claims 1).
In the context of evidence-based medicine and the rational use of antibiotics, it is clear that antibiotics should be preferred according to the culture antibiogram results in the treatment of infectious diseases 2).
Surgery
In 1910, Taylor 3) described the hemilaminectomy technique.
Posterior lateral mass fusion was later added to Albee 4) and Hibbs’s technique in 1911 5) , which remained the standard for 5 decades. This was first utilized for instability in patients with Pott’s disease.
Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment.
The role of surgical debridement and fusion with TB is controversial, and good results may be obtained with either medical treatment or surgery. Surgery may be more appropriate when definite cord compression is documented or for complications such as abscess or sinus formation 6) or spinal instability.