Journal de la colonne vertébrale

Spinal Tuberculosis: Rethinking an Old Disease

Abstract

Sofia Esteves, Isabel Catarino, Daniel Lopes and Carlos Sousa

Despite of the fact that the earliest cases of Spinal Tuberculosis date from 2400 BC, the first modern description was made in 1779 by Sir Percival Pott in the European population. The improvement of public health measures and the introduction of effective anti-tuberculosis drugs have made the infection virtually eradicated in developed countries. However, migration phenomena, the infection by human immunodeficiency virus (HIV) and other causes of immunodeficiency as diabetes and cancer chemotherapy have led to a resurgence of tuberculosis in parts of the world where the disease was sporadic or unknown. It is currently considered a public health problem, both in developed and developing countries.

Recently the clinical and radiological features of Spinal Tuberculosis have changed considerably. Atypical presentations are more common nowadays. The improvement of diagnosis and terapeutic management has lead to better clinical outcomes. However, early diagnosis and appropriate treatment remain the mainstay predictors of successful outcomes, preventing the most serious complications of Spinal Tuberculosis: neurological deficits and spinal deformities.

The main aim of this review is to discuss the historical aspects of the disease management as well as the most recent challenges. The authors included articles with acceptable design, clearly explained results and justified conclusions according to the data, regardless of their time of publication.