(i) Tuberculosis of the spine: current views in diagnosis, management, and setting a global standard

Spinal tuberculosis (TB) is the most common form of osteoarticular TB occurring in approximately half of all cases. It is also the most dangerous form, potentially causing paralysis, permanent neurological deficits and severe deformity. There has been a resurgence of TB over the last decade. This is mostly due to increased host susceptibility from the growing number of immunocompromised patients secondary to human immunodeficiency virus and acquired immunodeficiency syndrome, the wider use of immunosuppressant agents, the ageing population, and an increasing number of chronically debilitated patients. Although a minor factor, the recent re-emergence of multi-drug resistant variants of Mycobacterium tuberculosis hints at a possible further resurgence of TB in the coming years. Individualized treatment according to broad-spectrum management is essential for recovery. This article discusses the immunology, clinical manifestations, diagnosis, and medical and surgical treatments of spinal TB.