Letter to the Editor: Variability in Management Practices and Surgical Decision Making in Spinal Tuberculosis

Dear Editor,

We would like to share ideas on the publications regarding “Variability in management practices and surgical decision making in spinal tuberculosis: an expert survey-based study [1].” Ahuja et al. [1] concluded that “Significant variability was detected in treatment practices for the management of spinal tuberculosis among experts. Most of the case vignettes were found to have significant heterogeneity with respect to surgical decision making, which reflects a significant lack of consensus and lacunae in literature [1].” We agree that spinal tuberculosis is still an important clinical problem in several countries. The management of the patient is basically based on the antituberculotic drug therapy combined with surgical removal for cases with compression problems. However, the regimen of treatment might be different in different settings, which is mainly to the epidemiology of tuberculosis. Drug resistance in a different setting is an important determinant for the selection of antituberculotic management [2]. In the current study, Ahuja et al. [1] studied ideas of few fellowship-trained spinal tuberculosis experts, the training background of the subjects might be an important determinant for decision making. In addition, the decision-making might also be related to the local facilities in surgical management. Adding to the present study, if there is a consensus among these subjects to get a final recommendation and guidelines, it will be very useful. To achieve that data, the Delphi method-based study might be used.