Demographics of tuberculosis of spine and factors affecting neurological improvement in patients suffering from tuberculosis of spine: a retrospective analysis of 312 cases

Sharma, Ayush; Chhabra, Harvinder Singh; Chabra, Tarun; Mahajan, Rajat; Batra, Sahil; Sangondimath, G

doi:10.1038/sc.2016.85

Cited by 35 publications

(28 citation statements)

References 21 publications

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“…In our analysis of 783 bacteriologically/histopathologically confirmed cases of spinal tuberculosis, 677 (86.5%) patients had a typical MRI picture, which was comparable with the study conducted by A Sharma in New Delhi who found 264 (84.62%) patients had a typical MRI picture [ 30 ]. Conservative medical treatment in patients without deformities and neurological dysfunction resulted in clinically successful therapeutic responses in 93.8% of the patients in our study, which is close to Kotil K's research [ 31 ].…”

Section: Discussionsupporting

confidence: 87%

Analysis of Treatment and Prognosis of 863 Patients with Spinal Tuberculosis in Guizhou Province

Cao

Rao

Cai

et al. 2018

BioMed Research International

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The objective of this study was to investigate the treatment and prognosis of patients with spinal tuberculosis in Guizhou province. A total of 863 patients with spinal tuberculosis admitted to our hospital from 2006 to 2017 were included in this study. All patients underwent standardized quadruple antituberculosis treatment. Eighty patients were lost to follow-up due to a change of their contact information or noncompliance. A total of 783 patients completed the follow-up. The average follow-up period was 20.33 ± 8.77 months (range: 6 to 38 months). Among these patients, 145 patients underwent conservative treatment, while 638 patients underwent surgical treatment. All patients in the surgery group were treated with lesion removal, bone graft fusion, and internal fixation. Preoperative and postoperative standard quadruple antituberculosis treatment was administered. The clinical efficacy was evaluated according to erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), visual analogue scale (VAS), Cobb angle correction, neurological functional recovery, and interbody fusion with bone graft and tuberculosis outcome. A total of 608 patients achieved clinical cure. The symptoms, physical signs, blood tests and imaging findings were improved in 143 patients. Twenty patients showed refractory clinical symptoms, and 12 patients had local tuberculosis recurrence. Conservative and surgical treatments are the mainstream treatments for spinal tuberculosis. According to the patients' individual conditions, individualized treatments should be used to achieve good efficacy. Standardized antituberculosis treatment should be applied over the course of spinal tuberculosis.

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Section: Discussionsupporting

confidence: 87%

Analysis of Treatment and Prognosis of 863 Patients with Spinal Tuberculosis in Guizhou Province

Cao

Rao

Cai

et al. 2018

BioMed Research International

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“…In contrast to the report by Peto et al [16], 50% of lesions were involved in the thoracic and lumbar spine. MRI and CT are still the most useful modalities for detecting spinal lesions, especially MRI, which has good sensitivity and specificity [17], shows lesions typical of discitis, detects epidural spread, and paraspinal abscesses earlier than other imaging studies [18].…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Management of Spinal Tuberculosis in Tuberculosis Endemic Area of Guizhou Province: A Retrospective Study of 597 Patients in a Teaching Hospital

Wang

Liao

Cao

et al. 2020

BioMed Research International

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Background. Tuberculosis (TB) is an endemic disease in Guizhou. Spinal TB accounts for approximately 50% cases of skeletal TB. The purpose of this study was to investigate the characteristics and management of patients treated for spinal TB in a certain hospital and to provide guidance for the prevention and treatment of spinal TB. Methods. The clinic records of all patients diagnosed with spinal tuberculosis in a teaching hospital between January 2010 and December 2018 were collected. The epidemiology, clinical characteristics, imaging and laboratory findings, treatment methods, and prognosis were recorded and analyzed. Results. During this nine-year period, 597 patients with spinal TB were identified. There were 313 males and 284 females with an average age of 43 years. The largest number of patients fell in the age group of 21–30 years; mean time from symptom onset to diagnosis in the hospital was 17 months. Back pain was the main clinical manifestation (89.34%). The most common imaging technique was computed tomography (CT, 96.80%), followed by magnetic resonance imaging (MRI, 84.01%). Majority of the lesions involved the lumbar spine (47.30%), followed by the thoracic spine (40.95%). 178 (29.82%) patients in this study had varying degrees of neurological impairment. 22.78% of the patients selected conservative treatment, and surgical treatment was performed in 483 patients (80.90%). Conclusions. The incidence of spinal TB was generally on the rise throughout the study period. After diagnosed with spinal TB, all patients got appropriate treatment and achieved good efficacy, but most of the patients did not pay much attention to the disease and receive timely treatment. Thus, it is essential to strengthen the TB preventive strategies, improve the health awareness of residents and universal resident health examination.

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“…These indications are the same as previously reported by Liang et al (18) as follows: (1) Both endplates of the diseased vertebrae shall be intact to provide a secure host bed for graft fusion. (2) kyphosis deformity should be < 60 0 . 3 Some potential shortcomings of this study should be considered.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal TB has increased because of the increased human immunodeficiency virus (HIV) epidemic and drug resistance. Lumbar tuberculosis is very threatening because it may lead to bone destruction, deformity, and paraplegia (1,2).…”

Section: Introductionmentioning

confidence: 99%

Mono-segment fixation method versus short-segment fixation methods, in treatment of mono-segmental lumbar tuberculosis; using titanium mesh cage with interbody fusion retrospective case-control study.

Author)¹,

Manini

Wang

2020

Preprint

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Background ： 1/3rd-2/3rd of the remaining vertebral height can hold and withstand the standard pedicle screws; some surgeons have adopted affected vertebral fixation to avoid the complications of both long and short segment fixation during surgical correction of lumbar tuberculosis (TB).This study aimed to compare efficacy of mono-segment-fixation versus the short-segment fixation methods with the use of titanium mesh-cage (TMCs) and interbody fusion in the treatment of mono-segmental lumbar spinal TB via single stage posterior-only approach. Methods ： A retrospective review was done among 34 lumbar spinal TB patients. These patients underwent debridement, interbody fusion with (TMCs) by either Mono-segment fixation or short-segment fixation methods. Eighteen patients underwent mono-segment fixation method, group (A). While 16 patients underwent short-segment fixation method, group (B). Fusion, deformity correction, and decompression were done within the affected segment in group (A), while for group (B) fusion extended one level above and below the affected vertebrae . Operation time, intra-operative blood loss, degree of deformity correction and neurological functions were analyzed. Results: Comparing group (A) vs (B), average operation time in minutes (mins) for group A was 144.2±16.5, group B was 170.3 ± 25.0 (P=0.001). Average intraoperative blood loss in milliliter (mls) was 502.8±151.9 for group (A) and 742.5±143.2 for group (B) (p ˂0.05). The mean cobb’s angle between group A versus group B; preoperative was 23.8 ± 6.5 0 vs 22.2±9.2 0 (p=0.6), immediate post operatively was 8.0±3.5 0 vs 8.3±5.7 0 (p=0.847) and at final follow-up was 8.9±3.1 0 vs 9.2 ± 5.9 0 (p=0.866) respectively. Correction rate between group (A) vs group (B) was 15.7±3.8 0 vs 13.9±5.5 0 (p=0.285) and loss of correction was 1.2±0.7 0 vs 1.1±0.7 (p=0.817) respectively. No significant differences in neurological recovery between the two groups were founds. Conclusion: Under precise conditions: mono-segment fixation method, debridement, interbody fusion with TMCs, and posterior instrumentation can effectively reconstruct the spine, maintain stability and correct kyphosis deformity similar to short-segment fixation method. Also, it can relieve pain and improve neurological symptoms. When used in combination with anti-TB chemotherapy in the treatment of mono-segmental lumbar TB via a single-stage posterior-only approach.

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Demographics of tuberculosis of spine and factors affecting neurological improvement in patients suffering from tuberculosis of spine: a retrospective analysis of 312 cases

Abstract: In management of patients suffering from tuberculosis of spine, levels of vertebral involvement, AIS grade at presentation, bladder and bowel involvement and its duration significantly affect the final neurological improvement.

Cited by 35 publications

References 21 publications

Analysis of Treatment and Prognosis of 863 Patients with Spinal Tuberculosis in Guizhou Province

Analysis of Treatment and Prognosis of 863 Patients with Spinal Tuberculosis in Guizhou Province

Characteristics and Management of Spinal Tuberculosis in Tuberculosis Endemic Area of Guizhou Province: A Retrospective Study of 597 Patients in a Teaching Hospital

Mono-segment fixation method versus short-segment fixation methods, in treatment of mono-segmental lumbar tuberculosis; using titanium mesh cage with interbody fusion retrospective case-control study.

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