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Have TB in spine, L1 vertebra collapse. Suggested surgery. Is it required?

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Spine Surgeon
Practicing since : 1998
Answered : 116 Questions
Spinal TB, doctor suggested to go for Surgery Please suggest.

Hi Doc, Our doctor advised to go for spine surgery within 2 weeks because there was finding of the TB in spine and L1 vertebra is collapse, if we delay it may bend and once it is bend nothing can be done. I have also read that spine can get well without the surgery on medication. Please suggest if we need to go for spinal surgery. will attach the MRI scan films and reports
Posted Wed, 26 Sep 2012 in Osteoporosis
Answered by Dr. S K Mishra 35 minutes later

Thanks for posting your query and uploading the reports. I have seen them.

Your question is very genuine and yes, TB (Tuberculosis) spine can get well without surgery, provided
1. Your patient has no neurological deficit.
2. She has to remain bed ridden for at least 6 weeks.
3. Get a repeat MRI (Magnetic Resonant Imaging) after 6 weeks of AKT-4 and see the progress.
4. In the meantime, you have to remain prepared for any sudden neurological deterioration, which may warrant surgical intervention, because ATT takes about 1 month to act.

Hope this satisfies you, however ultimate decision can only be made by examining the patient and you should ask your treating doctor whether your case has nonsurgical option anyhow. You might consult another spine surgeon as well.

Hope this helps you. Do let me know if you have more concerns.

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Follow-up: Have TB in spine, L1 vertebra collapse. Suggested surgery. Is it required? 40 minutes later
Thanks doctor for the prompt and helpful reply, the query which we still have is to go for the surgery now or should we wait after doing bed rest for 6 weeks because doctor gave us time of maximum of 2 weeks to go for surgery or else spine can bend and then they wont be in a position to do anything.
Waiting for the reply !!

Thanks once again.

Answered by Dr. S K Mishra 1 hour later
As I already mentioned you can take opinion of other spine / neurosurgeon. In nonsurgical management you have to be very careful about minimum 6 wks absolute bed rest of patient including bedside toilet and urine and even once patient tries to get up on her own can create havoc as your doctor warned . However I may not not be best judge for your patient as complete examination of patient is necessary and doctor may have been finding subtle signs as well as he might be afraid of risk of conservative management.
Thank you.
Above answer was peer-reviewed by
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