RESEARCH ARTICLE
Spinal Tuberculosis – Directly Observed Treatment and Short Course or Daily Anti Tubercular Therapy -Are We Over Treating?
Ravinder Kumar Banga1, Jagdeep Singh2, *, Anshul Dahuja2, Radhe Shyam Garg2
Article Information
Identifiers and Pagination:
Year: 2018Volume: 12
First Page: 380
Last Page: 388
Publisher ID: TOORTHJ-12-380
DOI: 10.2174/1874325001812010380
Article History:
Received Date: 19/4/2018Revision Received Date: 8/5/2018
Acceptance Date: 15/8/2018
Electronic publication date: 28/09/2018
Collection year: 2018
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Study Design:
Prospective randomised control trial.
Purpose:
To compare the effectiveness of Directly Observed Treatment and Short Course (DOTS) and Daily Anti Tubercular Therapy (ATT) in spinal tuberculosis with no neurological deficit.
Overview of Literature:
Spinal tuberculosis is rampant in India with a major cause of morbidity and mortality. There is a lot of conflict regarding management with anti tubercular drugs, the regimen to be followed and the duration the drugs needed for complete cure.
Material and Methods:
This prospective study was conducted during the period of 2006 to 2009. Thirty cases of spinal tuberculosis were randomly divided equally into two groups of fifteen each and treated with DOTS and Daily ATT and compared at the end of follow up on clinical, radiological and Erythrocyte Sedimentation Rate values (ESR).
Results:
Pain score on Visual Analogue Scale (VAS) exhibits that mean pain score was 5.93+_1.54 at start and 0.64+_1.01 at the end of follow up with 89.39% change with DOTS therapy whereas mean pain score was 7.08 +_1.61at start of therapy and 0.69+_0.95 at end of follow up with 91.73% change in patients treated with Daily ATT with p value >0.05 (not significant). The radiological recovery in patients with DOTS and Daily ATT have similar results after 1.5 years with p value > 0.05 showing that the radiological recovery by both treatment modalities are comparable. Mean change in ESR scores in DOTS therapy patients and patients on daily ATT were 74.57+_9.34% and 75.69+_9.38% change with p value >0.05 which was not significant.
Conclusion:
DOTS therapy is an effective means of management of spinal tuberculosis cases with no neurological involvement, however its efficacy in patients with neurological deficit is further to be evaluated.
