Healing Assessment of Spinal Tuberculosis: A Systematic Review.

Systematic Review PURPOSE: Deciding the healing endpoint in spinal tuberculosis (STB) is remaining as a controversial topic. The current systematic review aims to address the controversy existing in the literature to find a comprehensive method to assess healing in STB. A thorough literature search was carried out for studies with the assessment of healing parameters in spinal tuberculosis. Data extraction was carried out manually which included study characteristics, and healing criteria evaluated in each study. Qualitative analysis of 8 included studies revealed healings parameters description in three domains - clinical, haematological, and radiological response of the patient to ATT. Each domain included various individual parameters, with clinical and radiological assessment criteria being used in most of the studies. Improvement in terms of pain, constitutional symptoms, weight gain, neurology; variation in ESR and CRP; changes in X-Ray, MRI, and PET-CT were found to be promising predictors in the assessment of healing. Radiological response parameters came out to be maximally used criterion to assess healing in spinal tuberculosis. However, in absence of any statistical analysis and observed lag in radiological response the cumulative effect of all the parameters in three domains- clinical, haematological, and radiological can be used for declaring a spinal tubercular lesion non-healing, healing, or healed.

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.