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The clinical and radiographic manifestations of maturity-onset tuberculous spondylitis were analyzed in 107 patients. If Mycobacterium tuberculosis (MBT) is drug resistant, the extent and degree of spinal bone destruction, the extent of abscess formation, and the rate of neurological disorders are greater than those in the MBT drug sensitivity group; however, the significant difference concerns only the involvement of vertebral arches in destruction. The pattern and activity of a tuberculous process in the lung and the proportion of bacteria-excreting persons with drug resistance in MBT significantly exceed those with drug sensitivity. All the patients were operated on; the diagnosis was histologically verified in 100% of cases; the postoperative specimens exhibited MBT culture in 72.9%; the polymerase chain reaction was positive n 98.9%. Bacteriological and molecular genetic studies established multiple drug resistance in 73.4%, polyresistance in 17.3%, and monoresistance in 9.3%.

The clinical and radiographic manifestations of maturity-onset tuberculous spondylitis were analyzed in 107 patients. If there is drug resistance in Mycobacterium tuberculosis (MBT), the extent and degree of spinal bone destruction, the extent of abscess formation, the rate of neurological disorders are greater than those in the MBT drug sensitivity group; however, the significant difference concerns only the involvement of vertebral arches in destruction. The pattern and activity of a tuberculous process in the lung and the proportion of bacteria-excreting persons with drug resistance in MBT significantly exceed those with drug sensitivity. All the patients were operated on; the diagnosis was histologically verified in 100% of cases; the postoperative specimens exhibited MBT culture in 72.9%; the polymerase chain reaction was positive n 98.9%. Bacteriological and molecular genetic studies established multiple drug resistance in 73.4%, polyresistance in 17.3%, and monoresistance in 9.3%.

Thirty-five case histories were analyzed in patients with tuberculous spondylitis (TS) in the presence of HIV infection. The peculiarity of TS in HIV-infected patients is a preponderance of the disseminated and multiple forms of spinal lesion. The patients of this category versus those without HIV infection also tended to have a higher rate of significant neurological disorders (types A-C by the ASIA scale, 1992). With drastically suppressed immunity, the patients with TS and HIV infection (blood CD4+ levels of less than 200 cells/µl of blood) had the disseminated forms significantly more frequently (χ2 = 1.480; p = 0.089) and cases of multiple locations (χ2 = 4.174; p = 0.124) in the vertebral column.