SPINAL TUBERCULOSIS: ROLE OF MRI IN DECIDING THE DURATION OF ANTITUBERCULAR THERAPY

Introduction: The most common extrapulmonary location of TB is the spine, accounting for more than 50% of musculoskeletal TB. MRI is the most valuable method for detecting early disease and is the preferred technique to dene the activity and extent of infection. It is also considered the imaging modality of choice for followup of tuberculous patients managed by operative or nonoperative treatment of tuberculous spine. Follow-up MRI can make a big difference in spinal tuberculosis; it can clearly show the change in the vertebral body and intervertebral space, paraspinal abscess, and the kyphosis angle after the treatment, which can provide a reference for clinical treatment and estimating prognosis. Role of MRI in deciding stoppage of anti-tubercular treatment in spinal tuberculosis. Aims and Objectives: Materials and Methods: This is a retrospective and prospective observational study on 62 patients of all ages and either sex of spinal TB who sequentially underwent MRI pre-treatment and every 6 months after starting treatment till complete resolution. Results: Out of 62 spinal tuberculosis patients, higher incidence is noted in females (42 patients,65%) with the most common age group affected being 21 to 30 years (20 patients,32%) with predominant involvement of thoracic spine (35 patients, 56.5%) followed by lumbar spine (16 patients,25.8%) and cervical spine (3 patients,4.8%), with 8 patients (12.9%) having skip lesions. Of 62 patients, 34 (54.8%) were positive for gene expert, and 17(27.4) were positive for culture. 36 (56%) patients underwent decompression and instrumentation, and 26 (46%) were managed conservatively. At the end of the study,42 patients showed complete or near complete resolution. A total (42 patients,67.7%) had stopped AKT based on MRI resolution. The remaining 20 patients (32.3%) with partial and no resolution were continued on AKT for 18 months. MRI is the bes Conclusion: t modality to diagnose and monitor response to antitubercular treatment and is the best modality to stop antitubercular therapy depending upon complete resolution.