Pathogenesis and Therapeutic Advances in Spinal Tuberculosis: A Comprehensive Review
DOI:
https://doi.org/10.54097/tjrqkh87Keywords:
Spinal Tuberculosis, Pathogenesis, Anti-tuberculosis Agents, Surgical Treatment, Therapeutic AdvancesAbstract
This review systematically explores the pathogenesis of spinal tuberculosis, emphasizing the interplay among Mycobacterium tuberculosis transmission routes, host immune responses, and anatomical and physiological characteristics of the spine. It also provides a comprehensive summary of current therapeutic advances, including optimized regimens of conventional anti-tuberculosis chemotherapy, surgical interventions, and emerging technologies such as local drug delivery systems, 3D printing, and targeted therapies. The aim is to offer clinicians an in-depth theoretical framework and therapeutic reference to further improve the diagnosis and treatment of spinal tuberculosis.
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[1] Ali A, Musbahi O, White VLC, Montgomery AS. Spinal tuberculosis: a literature review. JBJS Rev. 2019;7:e9. doi:10. 2106/JBJS.RVW.18.00035.
[2] Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med. 2011;34(5):440–454.
[3] Kumar K. Spinal tuberculosis, natural history of disease, classifications and principles of management with historical perspective. Eur J Orthop Surg Traumatol. 2016; 26:551–558. doi:10.1007/s00590-016-1811-x.
[4] Dunn RN, Ben Husien M. Spinal tuberculosis. Bone Joint J. 2018;100-B:425–431. doi:10.1302/0301-620X.100B4.BJJ-2017-1040. R1.
[5] Ryu SY, Patel R. Microbiology of bone and joint infections. In: Bone and Joint Infections. Chichester: John Wiley & Sons, Ltd; 2015. p. 5–20. doi: 10.1002/9781118581742.ch2.
[6] Chen T, Blanc C, Eder AZ, et al. Association of human antibodies to Arabinomannan with enhanced mycobacterial opsonophagocytosis and intracellular growth reduction. J Infect Dis. 2016;214(2):300–310. doi:10.1093/infdis/jiw141.
[7] Cheng JMH, Liu L, Pellicci DG, et al. Total synthesis of Mycobacterium tuberculosis dideoxymycobactin-838 and stereoisomers: diverse CD1a-restricted T cells display a common hierarchy of lipopeptide recognition. Chem. 2017;23 (7): 1694–1701. doi:10.1002/chem.201605287.
[8] Mahon RN, Sande OJ, Rojas RE, et al. Mycobacterium tuberculosis ManLAM inhibits T-cell-receptor signaling by interference with ZAP-70, Lck and LAT phosphorylation. Cell Immunol. 2012;275(1–2):98–105. doi:10.1016/j. cellimm. 2012. 02.009.
[9] Lisi L, Ciotti GMP, Braun D, et al. Expression of iNOS, CD163 and ARG-1 as M1 and M2 markers of microglial polarization in human glioblastoma. Neurosci Lett. 2017;645:106–112. doi: 10.1016/j.neulet.2017.02.076.
[10] Li Y, Wang Y, Ding H, et al. Pathologic characteristics of spinal tuberculosis: analysis of 181 cases. Int J Clin Exp Pathol. 2020;13(5):1253–1261.
[11] Tang L, Fu CG, Zhou ZY, et al. Clinical features and outcomes of spinal tuberculosis in Central China. Infect Drug Resist. 2022; 15: 6641–6650. doi:10.2147/IDR.S384442.
[12] Jain AK, Jaggi KR, Bhayana H, Saha R. Drug-resistant spinal tuberculosis. Indian J Orthop. 2018;52(2):100–107. doi:10. 4103 / ortho.IJOrtho_306_17.
[13] Alam MS, Phan K, Karim R, et al. Surgery for spinal tuberculosis: a multi-center experience of 582 cases. J Spine Surg. 2015;1(2):65–71. doi:10.3978/j.issn.2414-469X.2015. 07.03.
[14] Kilinc F, Setzer M, Behmanesh B, et al. Surgical management and clinical outcome of cervical, thoracic and thoracolumbar spinal tuberculosis in a middle-European adult population. Sci Rep. 2023;13:7000. doi:10.1038/s41598-023-34178-9.
[15] Kumar V, Salaria AK, Aggarwal A, Dhatt SS. Surgical approaches in management of spinal tuberculosis. Ann Natl Acad Med Sci. 2021;57:214. doi:10.1055/s-0041-1731596.
[16] Tang Y, Wu W, Yang S, et al. Surgical treatment of thoracolumbar spinal tuberculosis: a multicentre, retrospective, case-control study. J Orthop Surg Res. 2019;14:233. doi: 10. 1186/ s13018-019-1252-4.
[17] Pee YH, Park JD, Choi YG, et al. Anterior debridement and fusion followed by posterior pedicle screw fixation in pyogenic spondylodiscitis: autologous iliac bone strut versus cage. J Neurosurg Spine. 2008;8(5):405–412.
[18] Przybylski GJ, Sharan AD. Single-stage autogenous bone grafting and internal fixation in the surgical management of pyogenic discitis and vertebral osteomyelitis. J Neurosurg. 2001;94(1 Suppl):1–7.
[19] Zhang X, Wang KR, Gao X, et al. Endoscopic vertebral debridement and lavage drainage in the treatment of lumbar tuberculosis. Chin J Bone Joint. 2020;9(7):516–521.
[20] Guan XL, Xue W, Wang D, et al. Clinical application of percutaneous spinal endoscopy debridement and lavage in sacroiliac joint tuberculosis. Zhongguo Gu Shang. 2021;34 (11):1006–1010. doi:10.12200/j.issn.1003-0034.2021. 11.004.
[21] Lou YM, Zhu ZA, Huang QX, et al. Clinical observation of lumbar tuberculosis treated by lesion lavage and drainage at the upper edge of the pedicle. J Minim Invas Med. 2018;13(3):393–395.
[22] Wang ZY, Zhang ZY, Sun RF, et al. Clinical value of CT guided percutaneous catheter drainage for lumbar spinal tuberculosis with major lumbar abscess. J Clin Med. 2016;3 (33): 6513–6514.
[23] Li W, Liu Z, Xiao X, et al. Early surgical intervention for active thoracic spinal tuberculosis patients with paraparesis and paraplegia. BMC Musculoskelet Disord. 2021;22(1):213.
[24] Jain AK, Kumar J. Tuberculosis of spine: neurological deficit. Eur Spine J. 2013;22(Suppl 4):624–633.
[25] Khanna K, Sabharwal S. Spinal tuberculosis: a comprehensive review for the modern spine surgeon. Spine J. 2019;19 (11): 1858–1870. doi:10.1016/j.spinee.2019.05.002.
[26] Rivas-Garcia A, Sarria-Estrada S, Torrents-Odin C, et al. Imaging findings of Pott's disease. Eur Spine J. 2013;22(Suppl 4):567–578. doi:10.1007/s00586-012-2333-9.
[27] Wang Y, Shi S, Zheng Q, et al. Application of 3-dimensional printing technology combined with guide plates for thoracic spinal tuberculosis. Medicine (Baltimore). 2021;100(6):e24636. doi:10.1097/MD.0000000000024636.
[28] Pan JX, Xiong L, Zhao K, et al. YAP promotes osteogenesis and suppresses adipogenic differentiation by regulating beta-catenin signaling. Bone Res. 2018; 6:18. doi:10.1038/s41413-018-0018-7.
[29] Yang C, Wu K, Wang S, et al. Long non-coding RNA XIST promotes osteosarcoma progression by targeting YAP via miR-195-5p. J Cell Biochem. 2018;119(7):5646–5656. doi:10.1002/ jcb.26743.
[30] Xia XY, Yu YJ, Ye F, et al. MicroRNA-506-3p inhibits proliferation and promotes apoptosis in ovarian cancer cells via targeting SIRT1/AKT/FOXO3a signaling pathway. Neoplasma. 2020;67(2):344–353. doi:10.4149/neo_ 20201905 17N441.
[31] Peng X, Pu F, Zhou F, et al. Exploring expression levels of the cGAS-STING pathway genes in peripheral blood mononuclear cells of spinal tuberculosis patients. BMC Infect Dis. 2024; 24 (1): 915. doi:10.1186/s12879-024-09815-x.
[32] Johnson J, Kagal A, Bharadwaj R. Factors associated with drug resistance in pulmonary tuberculosis. Indian J Chest Dis Allied Sci. 2003; 45:105–109.
[33] Sharma SK, Mohan A. Multidrug-resistant tuberculosis. Indian J Med Res. 2004; 120:354–376.
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