Infection and Drug Resistance (Nov 2022)
Clinical Features and Outcomes of Spinal Tuberculosis in Central China
Abstract
Lei Tang,1,2,* Ce-Gang Fu,1,3,* Zhen-Yu Zhou,1,2 Si-Yu Jia,1 Zheng-Qiang Liu,1 Yun-Xiang Xiao,1 Hai-Dan Chen,1,2 Hui-Li Cai4 1Department of Spinal Surgery, Yichang Central People’s Hospital, China Three Gorges University, Yichang, People’s Republic of China; 2Graduate School, Ningxia Medical University, Yinchuan, People’s Republic of China; 3Department of Orthopedics, Haikou Orthopedic and Diabetes Hospital, Haikou Orthopedic and Diabetes Hospital of Shanghai Sixth People’s Hospital, Haikou, People’s Republic of China; 4Department of Hematology, Yichang Central People’s Hospital, China Three Gorges University, Yichang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hai-Dan Chen, Department of Spinal Surgery, Yichang Central People’s Hospital, China Three Gorges University, 183 Yiling Road, Yichang, 443003, Hubei Province, People’s Republic of China, Tel +86 18086220025, Email [email protected] Hui-Li Cai, Department of Hematology, Yichang Central People’s Hospital, China Three Gorges University, 183 Yiling Road, Yichang, 443003, Hubei Province, People’s Republic of China, Email [email protected]: The appropriate management of spinal tuberculosis (TB) is challenging for clinicians and the key to treat spinal TB. Surgery and long course anti-TB chemotherapy may not be necessary to all situations. This study aimed to characterize the clinical features and factors affecting treatment outcomes.Patients and Methods: A retrospective study of patients with spinal TB over a 5-year period at a teaching hospital in central China was conducted. Features of patients with spinal TB who received different treatment modalities and factors associated with patient outcomes at the end of chemotherapy were analyzed.Results: Forty-five patients (21 men and 24 women) with spinal TB were available for analysis. The mean age was 55.39 ± 14.94 years. The most common vertebral area involved was the lumbar (42.2%). The mean number of vertebrae involved was 2.20 ± 0.59. 27 patients (60.0%) received surgical treatment, of which 21 (77.8%) received radical surgical treatment. Thirty-five patients (77.8%) had achieved a favorable status. Statistically, there was no significant correlation between favorable status and surgery, but among 27 surgical patients with spinal tuberculosis, patients receiving radical surgery tended to achieve good prognosis (P = 0.010; odds ratio = 0.053; 95% confidence interval 0.006– 0.493). Moreover, there was no significant difference between long course and short course of anti-TB chemotherapy in prognosis in different treatment modalities.Conclusion: Although the patients with spinal TB who needed surgical treatment often got a better prognosis when they had radical surgery, surgery was not actually a factor for the favorable outcomes of patients with spinal TB. In different treatment modalities, there was no additional benefit in longer anti-TB chemotherapy periods.Keywords: surgical treatment, duration of anti-TB chemotherapy, retrospective study, outcome, spine, tuberculosis
