Clinical and radiological characteristics of the course of the newly diagnosed tuberculosis spondylitis in adults and the effectiveness of the main course of antimycobacterial therapy

Abstract

Study objective – set the frequency of detection of the newly diagnosed tuberculous spondylitis, the features of clinical and radiological manifestations of it and the effectiveness of the main course of antimycobacterial therapy. Materials and methods. To establish the frequency of a specific spondylitis in patients in the total number of cases of osteoarticular tuberculosis, a retrospective analysis of 197 patient history records for the period 2001–2015 was conducted. 38 medical records of subjects who were treated in the extrapulmonary tuberculosis department of the Municipal Institution "Zaporizhzhia Regional Tuberculosis Clinical Dispensary" of Zaporizhzhia Regional Council. The average age of patients was 50.3 ± 2.3 years. There were 14 (36.8 %) women and 24 (63.2 %) men. Study results were processed by modern methods of analysis on a personal computer using statistical software package Statistica® for Windows 6.0 (Stat Soft Inc., AXXR712 D833214FAN5). Results. It was established that for the period of 2001–2015 the frequency of cases of newly diagnosed tuberculosis spondylitis in the total structure of osteoarticular tuberculosis was 74.1%. The following features of the course of newly diagnosed tuberculosis spondylitis were established on the basis of the study of its clinical and radiological manifestations. In 84.2 % of cases, tuberculosis spondylitis develops predominantly as an independent disease. In all 100 % of cases there is an imperceptible start, slow progression and presence of local pain of varying degrees of severity in the area of vertebral column lesion. In 100 % of cases, the disease is accompanied by a destructive process of vertebrae bone tissue, including 84.2 % of floating abscess, and 86.9 % of simultaneous lesion of 2 adjacent vertebrae of the vertebral column. In 39.4 % of cases, it is accompanied by complications of a neurological nature. Assessment of effectiveness of the main course of antimycobacterial therapy in category 1 patients with the newly diagnosed tuberculosis spondylitis revealed that among 22 patients who received complete main course of treatment without operational intervention, it was effective in 86.3% patients. Conclusions. The frequency of newly diagnosed tuberculosis spondylitis is 74.1 %. The obtained data on the peculiarities of the course of the newly diagnosed tuberculosis spondylitis indicate a significant process severity that requires long-term treatment. The main course of antimycobacterial therapy for category 1 patients is quite effective, but given the severity and duration of the healing of a specific process, it is not long enough. There is high percentage of cases of refusal from inpatient treatment indicating the need for constant work among patients in relation to treatment adherence.

Keywords

• spinal tuberculosis
• treatment