Spinal Tuberculosis and Neurological Deficit A 10-Year Study in Rural Tertiary Care Center of Central India

Abstract

Background: India is a home for 27% of the world's tuberculosis (TB) cases. When compared, extrapulmonary TB (EPTB) cases have a lower incidence than pulmonary TB (PTB), but there is no significant reduction in the incidence of EPTB than PTB. Spinal TB is most common of skeletal TB. Aims: We aimed to study and to identify the clinical-radiological features in spinal TB and the incidence of neurological involvement along with factors associated with it. Settings and Design: This was a retrospective study in a tertiary care center of Central India. Subjects and Methods: A total of 114 cases with spinal TB were included in the study. Data collected retrospectively from January 2008 to December 2018 using a picture archiving and picture archiving and communication system of the hospital. Radiographs, magnetic resonance imaging scan, computed tomography, and ultrasound findings were studied. History and clinical examination findings were thoroughly analyzed. Statistical Analysis Used: Data were analyzed using Epi Info Software. Results: There were 74 (64.9%) male cases and 40 (35.1%) female cases. Most of the cases belong to rural 85 (74.5%) than urban 29 (24.5%) area. After neurological evaluation, paraparesis/paraplegia was observed in 52 (45.6%) cases and tetraplegia in 2 (1.7%) cases. Sensory deficit was observed in 10 (10.5%) cases. Bowel/bladder involvement was present in 5 (4.4% cases). Most of the cases with neurodeficit had dorsal vertebral involvement 30 (61.1%). Conclusions: The pattern of spinal TB is varied and is difficult to get diagnosed. We observed a high proportion of cases with neurodeficit. Most of them were with late-onset TB. This highlights that early diagnosis and complete treatment are very important in the treatment of TB of the spine.

Keywords

• extrapulmonary tuberculosis; pott's spine; spinal tuberculosis; tuberculosis