A 25-year-old male complaints of pain in lower back region for three months. Has history of slipping of bathroom slippers. Mild weakness of both lower limbs but can walk without support. There is 30% sensory loss and has bladder symptoms. D12-L1 is tender. X-ray shows paradiscal destruction of vertebrae and MRI shows destruction with indentation of thecal sac. Management is:
(d)ATT and Decompression as bladder symptoms are present.Indications of surgery in any disease of spine- Deterioration in neural or clinical status on treatment- No improvement in neural or clinical status after conservative trial of 3-4 weeks or- Bowel bladder involvement
Wait and watch
Domiciliary ATT
Admit and ATT
ATT and Decompression
TB of the Spine