{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:31:59Z","timestamp":1789129919894,"version":"build-2803163510"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the prevalence, patterns, diagnosis, and management of drug-resistant spinal tuberculosis (TB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, Scopus, Web of Science, and the Cochrane database from database inception to 14 February 2026, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Observational and experimental studies reporting drug resistance among patients with spinal TB were included. A random-effects meta-analysis was performed to estimate pooled proportions with 95% confidence intervals (CI). Risk of bias was assessed using the Joanna Briggs Institute checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nineteen studies involving 5,475 patients with spinal TB were included. The pooled prevalence of multidrug-resistant (MDR)-TB among spinal TB was 4.69% (95% CI: 3.03-7.20%; 16 studies). Rifampicin resistance was noted in 13.84% (95% CI: 3.07-44.90%; 6 studies). Drug susceptibility testing was most commonly performed after clinical or radiological non-response rather than as routine practice. Treatment approaches were heterogeneous, with MDR spinal TB typically managed using individualized second-line anti-TB regimens, frequently combined with surgical intervention. Low risk of bias was documented in 47.4% of studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The prevalence of MDR-TB among spinal tuberculosis was 4.69%. Considerable heterogeneity exists in drug susceptibility testing, diagnosis, medical treatment, and surgical management. The available evidence remains limited, underscoring the need for prospective studies evaluating the effectiveness of anti-TB regimens in MDR spinal tuberculosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261488395","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T17:05:01Z","timestamp":1788887101000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Global and Regional Patterns of Drug Resistance and Treatment Regimens in Spinal Tuberculosis: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-006X","authenticated-orcid":false,"given":"Shanmuganathan","family":"Rajasekaran","sequence":"first","affiliation":[{"name":"Ganga Medical Centre and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7167-2228","authenticated-orcid":false,"given":"Gnanaprakash","family":"Gurusamy","sequence":"additional","affiliation":[{"name":"Ganga Medical Centre and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5885-7152","authenticated-orcid":false,"given":"Ajoy Prasad","family":"Shetty","sequence":"additional","affiliation":[{"name":"Ganga Medical Centre and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-4909","authenticated-orcid":false,"given":"Rishi Mugesh","family":"Kanna","sequence":"additional","affiliation":[{"name":"Ganga Medical Centre and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek Uday","family":"Bicholkar","sequence":"additional","affiliation":[{"name":"South Asia Field Epidemiology and Technology Network (SAFETYNET), Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3609-5652","authenticated-orcid":false,"given":"Nadipalli","family":"Sathwik","sequence":"additional","affiliation":[{"name":"Andhra Medical College, Visakhapatnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nalabothu","family":"Bindu Vasanthi","sequence":"additional","affiliation":[{"name":"Andhra Medical College, Visakhapatnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SP","family":"Gogul","sequence":"additional","affiliation":[{"name":"Ganga Medical Centre and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravind P","family":"Gandhi","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2501-5543","authenticated-orcid":false,"given":"Gokul","family":"VV","sequence":"additional","affiliation":[{"name":"Seth Gordhandas Sunderdas Medical College (GSMC) and King Edward Memorial (KEM) Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1659-059X","authenticated-orcid":false,"given":"Mogan","family":"Kaviprawin","sequence":"additional","affiliation":[{"name":"Ganga Medical Centre and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"Global Tuberculosis Report","year":"2025","unstructured":"Global Tuberculosis Report 2025. https:\/\/www.who.int\/teams\/global-programme-on-tuberculosis-and-lung-health\/tb-reports\/global-tuberculosis-report-2025. 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