A practical therapeutic protocol for cervical tuberculosis

Abstract

Purpose: Cervical tuberculosis (CTB) is a relatively rare entity, even in endemic countries. Currently, management ranges from conservative to radical surgical approaches. We report our experience in diagnosing and treating 66 cases of CTB in the past eight years using our CTB therapeutic protocol.

Methods: All patients diagnosed with CTB were followed up over a 3.5-year period. Patients were divided into three grades using clinicoradiological criteria designed to evaluate the initial severity of the disease. Overall performance status was assessed based on the American Spinal Injury Association (ASIA) scale. Neurological recovery was evaluated with the ASIA scale as well as using X-rays and computed tomography every four weeks for the initial three months and every three months thereafter.

Results: The mean follow-up duration was 38.2 ± 6.2 months. No mortality occurred. One case of recurrence due to irregular antitubercular treatment (ATT) was cured by abscess clearing and regular ATT. All other patients had good clinicoradiological outcomes, regardless of grading.

Conclusions: The use of our proposed scoring system and management protocol allowed speedy management of CTB.

Keywords: Cervical tuberculosis; Management protocol; Pott’s spine; Scoring system.