Neurosurgical management of spinal tuberculosis and associated patient outcomes in Africa: a scoping review

Abstract

Spinal tuberculosis, also known as Pott’s disease, is one of the commonest forms of skeletal tuberculosis. It accounts for about 50% of musculoskeletal tuberculosis. It leads to deformity of the spine and neurological conditions if not treated properly. Multidrug anti-tubercular therapy remains the main treatment for spinal tuberculosis. However, in severe cases of spinal deformity or nerve compression, neurosurgical intervention may be required. The study reviewed 27 articles that reported neurosurgical approaches used to manage patients with spinal tuberculosis in different African countries. The surgical approaches used and outcomes of the treatment were extracted and reported. The review showed that surgery was mainly performed on patients with spinal deformity and other severe neurological conditions. Anterior decompression and posterior stabilization were major surgical techniques used, and in some cases, a combined approach was utilized alongside other neurosurgical techniques. The success of treatment was, in some cases, affected by late diagnosis and limited surgical facilities available to manage patients’ conditions in some African countries. Neurosurgical treatment plays an important role in managing various cases of spinal tuberculosis in Africa, with patients benefiting from surgery. However, challenges like late presentation and not enough surgical facilities continue to be limitations in neurosurgical approaches, affecting treatment outcomes.