Asian Spine J > Volume 13(1); 2019 > Article |
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Authors’ contribution
Arockiaraj J: design, analysis, interpretation of data, and draft manuscript; Robert M: analysis, interpretation of data, and draft manuscript; Rose W: analysis, correction, critical revision, and final approval; Amritanand R: correction, critical revision, and final approval of the draft; David SK: correction, critical revision, and final approval of the draft; and Krishnan V: correction, critical revision, supervision, and final approval.
No. | Intervention | Histopathology | Xpert/RIF assay | Culture | Drug susceptibility test | Drugs used in MDR treatment (24 mo) | Outcome | Complications |
---|---|---|---|---|---|---|---|---|
1 | Ex tended posterior circumferential decompression of the cord [14] | Ne crotising granulomatous lesion | Not done | Positive | Re sistant to I, R, E, S | Py r., Levo., Cyc., Eth., Amik. | Co mpleted treatment; improved to ASIA D; 47.8° kyphosis | Nil |
2 | Co sto-transversectomy of 8th rib left side and drainage of the abscess | Ne crotising granulomatous lesion | RIF resistant | Positive | Re sistant to I, R, E, S | Le vo., Cyc., Eth., Clar., PAS, Amik. | Completed treatment | Pr ogressive deformity to 102° kyphosis has been advised corrective surgery but parents were not willing for the surgery |
3 | CT guided biopsy–dorsal spine | Ne crotising granulomatous lesion | RIF resistant | Positive | Re sistant to I, R, E, ofloxacin | Py r., Levo., Cyc., Eth., Clar., Amik. | Completed treatment | Hy pothyroidism, transient hearing loss (15° in audiometry)–improved in 3 months |
4 | As piration of the local abscess under local anaesthesia | Not done | RIF resistant | Negative | Negative | Le vo., Cyc., Eth., PAS, Amik. | Completed treatment | Tr ansient hearing loss (15° in audiometry)–improved in 3 months |
5 | Ex tended posterior circumferential decompression of the cord | Ne crotising granulomatous lesion | RIF resistant | Positive | Re sistant to I, R, E, Eth. | Py r., Levo., Cyc., Clar., Amik. | Co mpleted 15 months of 2nd line antituberculous treatment; 20° kyphosis at D1–D4 and 10° kyphosis at D9–D11; neurology improved to ASIA D | Nil |
6 | CT guided biopsy–lumbar spine | Ne crotising granulomatous lesion | RIF resistant | Positive | Re sistant to I, R, E, S | Py r., Levo., Cyc., Eth., Clar., Amik. | Completed and healed | Nil |
MDR, multidrug-resistant; I, isoniazid; R, rifampicin; E, ethambutol; S, streptomycin; Pyr., pyrazinamide; Levo., levofloxacin; Cyc., cycloserine; Eth., ethionamide; Amik., amikacin; ASIA, American Spinal Injury Association; Clar., clarithromycin; PAS, para-amino salicyclic acid granules; CT, computed tomography.
No. | Studies on MDR: musculo skeletal tuberculosis in children | No. of children treated/site of the disease |
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1 | Schaaf et al. [21]: culture confirmed multidrug resistant tuberculosis: diagnostic delay, clinical features, and outcome | 2 Children with bone tuberculosis |
2 | Drobac et al. [22]: community-based therapy for children with multidrug-resistant tuberculosis | 1 Child with Pott’s disease |
3 | Mendez Echevarria et al. [23]: multidrug-resistant tuberculosis in the pediatric age group | 1 Child with arthritis underwent synovial biopsy |
4 | Seddon et al. [24]: culture-confirmed multidrug-resistant tuberculosis in children: clinical features, treatment, and outcome | 9 Children with bone/joint/spine |
5 | Our study | 6 Children with tuberculosis of the spine (exclusively) |