Evaluation of Investigations Suitable to Stop Treatment in Spinal Tuberculosis

Spinal tuberculosis is the most common extrapulmonary manifestation of tuberculosis and accounts for half of the cases of skeletal tuberculosis and 2% of all tuberculosis cases. The prevalence of spinal tuberculosis is widespread in an endemic county such as India where many people live under poor socioeconomic demographics. It is still a major cause of morbidity and economic loss as it generally affects the productive age groups and the deformities of spinal tuberculosis can have long-lasting effects on the affected population. Detection of drug-resistant strains is another worrying factor that contributes to the reemergence of spinal tuberculosis as a major cause of concern as it can lead to prolonged treatment and failure if not properly addressed on time. There is no proper gold standard investigation to reliably detect the endpoint of treatment in spinal tuberculosis and there is a lack of consensus regarding the exact duration of antitubercular therapy. This remains a gray area even today. This review article aims to look into some of the investigations that can help determine the endpoint of treatment with a special focus on magnetic resonance imaging (MRI) and positron emission tomography scan (MRI scan). Keywords: Spinal tuberculosis, magnetic resonance imaging scan, positron emission tomography scan