For spinal TB, should we go for surgery?

Question

Hi doctor,

My brother, who is 27 years old, has been suffering from back pain for the last nine months. Nine months ago, in the first MRI, the doctor told us it is a slipped disc. We took it lightly. He had painkillers, and due to excessive use of painkiller, he had a stomach ulcer. Now, the ulcer is gone. In the last 15 days, he has severe pain in his back. We consulted a physiotherapist. After two or three sessions, when the pain gets worse, the doctor advised us to do MRI again. I am attaching the MRI report so that you can get it better. We consulted an orthopedist and got to know that he has spinal TB. The doctor forced us for surgery, but we ignored. We requested him for chemotherapy. He gave us some medicine and Streptomycin injection. I am not getting which type of TB is it? Is it normal or MDR TB or XDR? Should we go for surgery? Please advise us what to do. The current medicines are Benadon 40 mg, Pyzina 750 mg, Combutol 800+400 mg, Nucoxia, R-Cinex 600 mg and Protera D.

Answer 1

Hi,

Welcome to icliniq.com.

I understand the scenario well. If it was only a spinal involvement, then we could have given only medicines and weighted for improvement. But here it is both, spinal involvement and abscess also (attachment removed to protect patient identity). An abscess is a collection of pus. It is a rule in medical science that abscess or pus collection anywhere in the body has to be drained. So, the surgery will serve a dual purpose. It will drain pus from the abscess in psoas muscle and also from the space above the sac of the spinal cord. I think you should go ahead with surgery. Regarding the type of TB, we can know only by microbiological analysis of the pus or abscess wall specimen that we obtain during surgery. You can continue the current medicines.

For spinal TB, should we go for surgery?

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