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What is the treatment for TB of the spinal cord?

Q: If a person is suffering from tuberculosis of the spinal cord, how much time does it take to recover properly? Does it affect the legs of a person? What should he do to regain 100% fitness?

A:Medical therapy for spinal TB requires a combination of at least 3 antituberculous drugs. Treatment can be adjusted when susceptibility information becomes available. INH and rifampin should be administered during the whole course of therapy. Additional drugs are administered during the first 2 months of therapy. These are generally chosen among the first-line drugs, which include pyrazinamide, ethambutol, and streptomycin. A 3-drug regimen usually includes INH, rifampin, and pyrazinamide. The use of second-line drugs is indicated in cases of drug resistance. The duration of treatment is slightly controversial. Although some studies favour a 6- to 9-month course, traditional courses range from 9 months to longer than 1 year. The duration of therapy should be individualised and based on the resolution of active symptoms and clinical stability of the patient. Current treatment modalities are highly effective if not complicated by severe deformity or established neurologic deficit. Paraplegia resulting from the active disease causing cord compression usually responds well to chemotherapy. If medical therapy does not result in rapid improvement, operative decompression will greatly increase the recovery rate. Paraplegia can manifest or persist during healing because of permanent spinal cord damage. The most important thing you can do to get well soon, is to ensure that you take the medicines as prescribed by the doctor.


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