{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:06:06Z","timestamp":1792101966344,"version":"4.4.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"963","license":[{"start":{"date-parts":[[2006,1,1]],"date-time":"2006-01-01T00:00:00Z","timestamp":1136073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The diagnosis of spinal tuberculosis (ST) is difficult and it commonly presents at an advanced stage. The management and follow up is complicated by a lack of guidance on the appropriate use and interpretation of spinal magnetic resonance studies (MR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>A retrospective study was performed at a UK centre to identify the demographic and presenting features of a spinal TB population, their response to treatment, and the value of follow up MR studies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and Results<\/jats:title>\n                  <jats:p>Twenty one patients were identified with mean symptom duration of 11 (1.5\u201336) months having been assessed by a health practitioner on 3.2 (0\u201310) occasions before referral for investigation for ST. Twenty were born outside the UK. Their mean duration of residence in the UK was 6.67 (0.75\u201320) years, and six (32%) were resident for more than 10 years. Most (85.7%) did not have a medical history and one was HIV positive. Back pain, neurological, and constitutional symptoms were found in 100%, 29%, and 38% respectively. Musculoskeletal and neurological signs were found in 29% and 19% respectively. Spinal MR performed between 6 and 12 months suggests that six months of chemotherapy (for a fully sensitive organism) may not be sufficient to achieve disease resolution.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Awareness of the demographic, clinical, and laboratory features of an ST population may facilitate earlier diagnosis. Guidance is required on the appropriate use and interpretation of MRI in the follow up of these patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/pgmj.2005.032862","type":"journal-article","created":{"date-parts":[[2006,1,5]],"date-time":"2006-01-05T18:34:13Z","timestamp":1136486053000},"page":"46-51","source":"Crossref","is-referenced-by-count":100,"title":["Current difficulties in the diagnosis and management of spinal tuberculosis"],"prefix":"10.1093","volume":"82","author":[{"given":"L","family":"Cormican","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Guy's and St Thomas' NHS Hospitals Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Hammal","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Guy's and St Thomas' NHS Hospitals Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Messenger","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Guy's and St Thomas' NHS Hospitals Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H J","family":"Milburn","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Guy's and St Thomas' NHS Hospitals Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2006,1,5]]},"reference":[{"key":"2023042013493841400_bib1","first-page":"19","article-title":"Medical Research Council National Survey of Tuberculosis Notifications in England and Wales in 1983: characteristics of disease","volume":"68","author":"Medical Research Council","year":"1988","journal-title":"Tubercle"},{"key":"2023042013493841400_bib2","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1227\/00006123-199501000-00011","article-title":"Modern management of spinal tuberculosis","volume":"36","author":"Rezai","year":"1995","journal-title":"Neurosurgery"},{"key":"2023042013493841400_bib3","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1136\/thx.52.12.1060","article-title":"Tuberculosis in England and Wales in 1993: results of a national survey","volume":"52","author":"Kumar","year":"1997","journal-title":"Thorax"},{"key":"2023042013493841400_bib4","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1136\/thx.53.3.176","article-title":"Geographical distribution of tuberculosis in national surveys of England and Wales in 1988 and 1993: report of the Public Health Laboratory Service\/British Thoracic Society\/Department of Health Collaborative Group","volume":"53","author":"Ormerod","year":"1998","journal-title":"Thorax"},{"key":"2023042013493841400_bib5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/00003086-200205000-00005","article-title":"Human immunodeficiency virus and osteoarticular tuberculosis","volume":"398","author":"Jellis","year":"2002","journal-title":"Clin Orthop"},{"key":"2023042013493841400_bib6","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/00003086-200205000-00011","article-title":"Treatment of tuberculosis of the spine with neurologic complications","volume":"398","author":"Jain","year":"2002","journal-title":"Clin Orthop"},{"key":"2023042013493841400_bib7","first-page":"1731","article-title":"Another look at spinal tuberculosis","volume":"20","author":"Fam","year":"1993","journal-title":"J Rheumatol"},{"key":"2023042013493841400_bib8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/00005792-199909000-00003","article-title":"Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980\u20131994","volume":"78","author":"Pertuiset","year":"1999","journal-title":"Medicine"},{"key":"2023042013493841400_bib9","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1136\/bmj.1.5593.682","article-title":"Failure of early recognition of skeletal tuberculosis","volume":"i","author":"Walker","year":"1968","journal-title":"BMJ"},{"key":"2023042013493841400_bib10","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1136\/thx.53.7.536","article-title":"Chemotherapy and management of tuberculosis in the United Kingdom: recommendations 1998","volume":"53","author":"Joint Tuberculosis Committee of The British Thoracic Society","year":"1988","journal-title":"Thorax"},{"key":"2023042013493841400_bib11","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1164\/rccm.167.4.603","article-title":"Centers for Disease Control and Prevention, Infectious Diseases Society of America. Treatment of tuberculosis","volume":"167","author":"American Thoracic Society","year":"2003","journal-title":"Am J Respir Crit Care Med"},{"key":"2023042013493841400_bib12","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1302\/0301-620X.75B2.8444944","article-title":"Controlled trial of short-course regimens of chemotherapy in the ambulatory treatment of spinal tuberculosis","volume":"75-B","author":"Twelfth report of the Medical Research Council Working Party on Tuberculosis of the spine","year":"1993","journal-title":"J Bone Joint Surg (Br)"},{"key":"2023042013493841400_bib13","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/0041-3879(86)90014-0","article-title":"A controlled trial of six-month and nine-month regimens of chemotherapy in patients undergoing radical surgery for tuberculosis of the spine in Hong Kong","volume":"67","author":"Tenth report of the Medical Research Council Working Party on Tuberculosis of the Spine","year":"1986","journal-title":"Tubercle"},{"key":"2023042013493841400_bib14","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s002640050311","article-title":"Five-year assessments of controlled trials of short course chemotherapy regimens of 6, 9 or 18 months' duration for spinal tuberculosis ambulatory from the start or undergoing radical surgery","volume":"23","author":"Medical Research Council Working Party on Tuberculosis of the Spine","year":"1999","journal-title":"Int Orthop"},{"key":"2023042013493841400_bib15","first-page":"259","article-title":"Chemotheraputic treatment for spinal tuberculosis","volume":"6","author":"Van","year":"2002","journal-title":"Int J Tuberc Lung Dis"},{"key":"2023042013493841400_bib16","volume-title":"Census 2001 topic report","author":"Lambeth Council"},{"key":"2023042013493841400_bib17","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00003086-199008000-00015","article-title":"Spinal tuberculosis in a developed country. Areview of 26 cases with special emphasis on abscesses and neurological complications","volume":"257","author":"Janssens","year":"1990","journal-title":"Clin Orthop"},{"key":"2023042013493841400_bib18","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/S0962-8479(96)90097-0","article-title":"Spinal tuberculosis in patients with human immunodeficiency virus infection: clinical presentation, therapy and outcome","volume":"77","author":"Leibert","year":"1996","journal-title":"Tuber Lung Dis"},{"key":"2023042013493841400_bib19","doi-asserted-by":"crossref","first-page":"243","DOI":"10.3171\/jns.1995.83.2.0243","article-title":"Spinal tuberculosis: a diagnostic and management challenge","volume":"83","author":"Nussbaum","year":"1995","journal-title":"J Neurosurg"},{"key":"2023042013493841400_bib20","first-page":"698","article-title":"Tuberculosis among immigrants related to length of residence in England and Wales","volume":"iii","author":"Report of the British Thoracic and Tuberculosis Association","year":"1975","journal-title":"BMJ"},{"key":"2023042013493841400_bib21","volume-title":"Morbidity statistics from general practice. Fourth national study 1991\u20131992","author":"Mc","year":"1995"},{"key":"2023042013493841400_bib22","first-page":"10","volume-title":"ABC of rheumatology","author":"Jenner","year":"1996"},{"key":"2023042013493841400_bib23","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/00007632-198709000-00002","article-title":"A new clinical model for the treatment of low bak pain","volume":"12","author":"Waddell","year":"1987","journal-title":"Spine"},{"key":"2023042013493841400_bib24","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/S0140-6736(00)02876-2","article-title":"HIV seroprevalence by anonymous testing in patients with Mycobacterium tuberculosis and in tuberculosis contacts","volume":"356","author":"Bowen","year":"2000","journal-title":"Lancet"},{"key":"2023042013493841400_bib25","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/00007632-199006000-00006","article-title":"MRI diagnosis of tuberculous vertebral osteomylitis","volume":"15","author":"Bell","year":"1990","journal-title":"Spine"},{"key":"2023042013493841400_bib26","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/00003086-200205000-00006","article-title":"Imaging of musculoskeletal tuberculosis: a new look at an old disease","volume":"398","author":"Griffith","year":"2002","journal-title":"Clin Orthop"},{"key":"2023042013493841400_bib27","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/00007632-199302000-00014","article-title":"Incomplete neural deficits in thoracolumbar and lumbar spine fractures. Reliability of Frankel and Sunnybrook scales","volume":"18","author":"Davis","year":"1993","journal-title":"Spine"},{"key":"2023042013493841400_bib28","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1136\/ard.56.12.709","article-title":"Pyogenic, tubercular, and brucellar vertebral osteomylitis: a descriptive and comparative study of 219 cases","volume":"56","author":"Colmenero","year":"1997","journal-title":"Ann Rheum Dis"},{"key":"2023042013493841400_bib29","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.2106\/00004623-198567090-00017","article-title":"Tuberculous spondylitis in adults","volume":"9","author":"Lifeso","year":"1985","journal-title":"J Bone Joint Surg"},{"key":"2023042013493841400_bib30","first-page":"72","article-title":"A controlled trial of debridement and ambulatory treatment in the management of tuberculosis of the spine in patients on standard chemotherapy: a study in Bulawayo","volume":"77","author":"Medical Research Council Working Party on Tuberculosis of the Spine","year":"1974","journal-title":"J Trop Med Hyg"},{"key":"2023042013493841400_bib31","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1002\/bjs.1800611102","article-title":"A controlled trial of anterior spinal fusion and debridement in the surgical management of tuberculosis of the spine in patients on standard chemotherapy: a study in Kong Kong","volume":"61","author":"Medical Research Council Working Party on Tuberculosis of the Spine","year":"1974","journal-title":"Br J Surg"},{"key":"2023042013493841400_bib32","first-page":"76","article-title":"A controlled trial of anterior spinal fusion and debridement in the surgical management of tuberculosis of the spine in patients on standard chemotherapy: a study in two centres in South Africa","volume":"59","author":"Medical Research Council Working Party on Tuberculosis of the Spine","year":"1978","journal-title":"Tubercle"},{"key":"2023042013493841400_bib33","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1136\/jcp.36.6.662","article-title":"Examination of the operation specimens from patients with spinal tuberculosis for tubercle bacilli","volume":"36","author":"Allen","year":"1983","journal-title":"J Clin Pathol"},{"key":"2023042013493841400_bib34","volume-title":"Antimicrobial resistance in England and Wales 2000","author":"Communicable Disease Surveillance Centre","year":"2000"},{"key":"2023042013493841400_bib35","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1302\/0301-620X.80B3.0800456","article-title":"A 15-year assessment of controlled trials of the management of tuberculosis of the spine in Korea and Hong Kong","volume":"80-B","author":"Thirteenth report of the Medical Research Council Working Party on Tuberculosis of the Spine","year":"1998","journal-title":"J Bone Joint Surg"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/82\/963\/46\/50024590\/postgradmedj-82-46.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/82\/963\/46\/50024590\/postgradmedj-82-46.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T17:01:01Z","timestamp":1682010061000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/82\/963\/46\/7045356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1,1]]},"references-count":35,"journal-issue":{"issue":"963","published-online":{"date-parts":[[2006,1,5]]},"published-print":{"date-parts":[[2006,1,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.2005.032862","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2006,1]]},"published":{"date-parts":[[2006,1,1]]}}}