Is spinal tuberculosis changing with changing time?

Abstract

Introduction Spinal tuberculosis is a chronic destructive disease with long-term morbidity. Patients are usually young especially from a poor socioeconomic background. Destruction of the intervertebral disk space and the adjacent vertebral bodies is the characteristic lesion. The dorsal spine is the most affected region with multi-level noncontiguous involvement being detected more frequently. Patients usually present with chronic back pain associated with spinal tenderness, paraplegia, spinal deformities, as well as with constitutional symptoms. Magnetic resonance imaging has proved to be more sensitive and specific for its diagnosis, but availability and affordability of this investigation remain a problem in developing countries. Anti-tuberculous drug therapy has revolutionized the treatment of this debilitating disease. Surgery is still required in selected cases especially with evolving neurological deficit, progressive deformity, intractable pain and lack of response to drug therapy. With early diagnosis and effective treatment, prognosis is generally good. Materials/Methods: After getting permission from the clinical governance department, We collected the retrospective data of 305 patients with diagnosed spinal tuberculosis, who underwent surgical intervention. Results There was no significant difference in incidence among males and females. Housewives were the most affected. Lower dorsal spinal was the commonest site involved but our study didn't confirm the incidence of multi-level disease process. Anterior decompression along with Cage fixation was most frequently performed procedure. Conclusion Despite the availability of highly effective antituberculous drugs, advanced surgical procedure, the spinal tuberculosis still maintains its demographic profile. There has been no change in characteristics of spinal presentation of this chronic debilitating disease. Patients continue to suffer the same way as they were suffering decades ago.

Spondylitis with epidural abscess and spinal tuberculoma as a major cause of myeloradiculopathy: a case report

“…Generally, the main complaints of most patients (90%) in the early stages are symptoms of back pain, weight loss, loss of appetite, and fever. Some also experience neck pain, weakness of the lower extremities, upper jaw, weakened limbs, and deformities [7] . The main complaints (83%-100% of cases) are back pain caused by disruption of the intervertebral disc and spinal instability, nerve compression, or pathological fracture, exacerbated by spinal movement, coughing, and weight-bearing [ 8 , 9 ].…”

Imaging update in spinal tuberculosis

“…Spinal tuberculosis shows increasing trending in recent years, and largest number of patients belong to the age group of 16e30 years. 11 Spinal tuberculosis can have varied presentations. Often, it is insidious in onset with long duration of history.…”

“…Back pain is the most common presentation, seen in 90%e100% of spinal tuberculosis, and is the only complaint in 61% of patients. 9,11 Constitutional symptoms such as fever, malaise, loss of appetite, and loss of weight which are common in pulmonary tuberculosis, are infrequent in spinal tuberculosis (20%e30%). Complicated spinal tuberculosis can present with deformity, instability, or neurological deficits.…”