SPINAL TUBERCULOSIS IN DEVELOPED-COUNTRIES - DIFFICULTIES IN DIAGNOSIS

A review of 21 cases of patients with spinal tuberculosis has been per formed, with special attention being paid to methods of diagnosis and the surgical treatment undertaken. We found that the clinical presenta tion of the condition was often similar to that of malignant disease w ithin the spine, with the commonest presenting features being back pai n (95%), an evaluated erythrocyte sedimentation rate (ESR) (100%) and neurological deficits (47%). The radiological appearances were diagnos tic of spinal tuberculosis in less than 50% of cases. Microbiological confirmation of the diagnosis was possible only by direct analysis of tissue or pus, either at operation or from a vertebral biopsy. The dif ficulty of diagnosing this condition and the implications that this ha s on the timing and nature of surgery in patients presenting with neur ological deficits are discussed.