Criteria for favorable outcome - all of the following:
(1) no symptoms
(2) full physical activity at work
(3) no evidence of CNS involvement (myelopathy, other)
(4) no sinus or abscess detected
(5) healing of spinal lesions on imaging studies
Factors associated with a better prognosis:
(1) younger age (age < 50 years)
(2) radical surgery
(3) completion of adequate anti-tuberculous chemotherapy (isoniazid and rifampin and ethambutol; 6 or 9 month regimen sufficient)
where:
• There was no benefit found for longer chemotherapy regimens.
• The mean age for the favorable group was 42 years +/- 16 years. The mean age for the unfavorable group was 52 +/- 16 years. The choice of 50 years is an oversimplification of the age distributions.
Radical surgery involves:
(1) anterior compression
(2) bone fusion
(3) instrumentation
(4) vertebral curettage
