Treatment of tuberculosis-associated vertebral compression with percutaneous vertebroplasty (PVP) relieves pain and prevents kyphosis

Background: Patients with suspected tuberculosis of the spine often present with back pain and/or neurological symptoms due to underlying compression fractures. Needle biopsy is frequently needed for confirmatory diagnosis. An additional surgical procedure may be required to stabilize the spine and prevent complications. Methods: T0 retrospectively reviewed medical records of 44 patients with suspected spinal tuberculosis from 2013–2017 who underwent bone biopsy for diagnosis and simultaneous PVP for stabilization of the spine. A follow-up telephone interview was conducted to evaluate the effect of treatment including the degree of post-surgical pain, presence of neurological symptoms, and kyphosis. Results: At the time of follow-up, 18 patients achieved complete remission, 6 patients underwent a second surgery and 1 patient had no change in the clinical course. Secondary systemic infection after PVP is not reported and the results suggest PVP is not an absolute contraindication in the patients with suspected spinal tuberculosis. PVP has demonstrated a significant improvement in pain one-day post-op and at the time of follow-up (from NRS 6.64 to NRS 1.33 and 0.64, respectively). Neurological symptoms (from 16–4%) and kyphosis (from 32–8%) also improved with PVP treatment. Conclusion: PVP is a feasible and effective technique for treating compression fractures due to spinal tuberculosis. It augments the fractured vertebrae, improves pain relief and prevents kyphosis. It does not help spread the infection and should not be regarded as a contraindication for infectious disease, particularly in the context of tuberculosis.