Medical Research Council (MRC) trial results led to the development of the middle path regimen, which was put forward by Dr. Tuli to manage patients with spinal tuberculosis and neurological deficits, making the indications for surgery more selective today [21,23,24]. The MRC trials divided patients into three prospective groups.

Jun 4, 2012 · Tuli's middle-path regimen is widely used with good results and short-course chemotherapy regimens have been demonstrated to have excellent results except in patients younger than 15 years with an initial angle of kyphosis of more than 30 degrees and whose kyphosis increases substantially .

It is suggested that treatment should in the first place be by modern antitubercular drugs. The efficacy of modern drugs in the treatment of tuberculosis of the spine has been evaluated by a personal follow-up for three to ten years.

May 18, 2020 · The presence of a stable, nonprogressive neurologic deficit is not an absolute indication for surgery in active spinal TB, as chemotherapy improves the neurologic outcome. 1, 2 Tuli 1 introduced a middle-path regimen, wherein he treated neurologic deficit patients initially with bed rest and antituberculous chemotherapy. Surgery was considered ...

Tuli, in 1975, proposed a ‘middle-path regimen’ for treatment of spinal tuberculosis. It advocates conservative treatment with multi-drug chemotherapy and surgery reserved for specific indications. 95

Tuli's middle-path regimen is widely used with good results . The British Thoracic Society recommends 6 months' duration for spine unless there is central nervous system involvement where they recommend 12 months therapy [ 22 ].

May 24, 2008 · Tuli’s middle-path regimen is widely followed in most resource-poor settings with good success rates [ 2 ]. Short-course chemotherapy regimens have been documented to lead on to cure of the disease [ 3 ].

Aug 21, 2013 · One hundred and eighty-one patients with spinal TB were included in the study. Of these, only 25 patients had a neurological deficit. What was the indication for surgery in the other patients? They could very well have been managed conservatively or with a middle-path regimen .

Sep 1, 2004 · Our results show that the transpedicular approach is a viable and safe surgical option for ventral decompression in thoracic spine tuberculosis, followed by chemotherapy for 18 months and immobilization in an alkathene shell for 3 months.

The middle path regimen for treating TB spine involves: 1. Initial rest and use of anti-tuberculosis drugs. 2. Regular radiographs and other scans to monitor the spine over a period of 2 years. 3. Gradually increasing mobilization with braces as the patient improves. 4.