<s>[INST] Dear Doctor, I Am diagnosed with Spinal epidural abscess along with non healing ulcer,along with Positive Mantoux test.Doctor has advised a major operation in which he will draining the pus which is collected at the abscess with small follow up. Is there some other way out rather than operation. [/INST] Hello dear,Your case seems to of tubercular involvement of spine with abscess and ulcer along with discharging sinus. You need to take anti tubercular drugs for 9-12  months. The decision of surgery depends upon compression on cord and associated neurodeficit and is not required in all cases.Hope you get the answer satisfactory. Wishing you good healthRegardsDr Neeraj KumarNeurologist </s>