Characteristics of patients with spinal tuberculosis: seven-year experience of a teaching hospital in Southwest China

Abstract

Purpose The purpose of this study was to investigate the characteristics of patients managed for spinal tuberculosis at the orthopaedics department of a teaching hospital in Chongqing, China, between 2004 and 2010. Methods The study used a retrospective chart review. The epidemiology, clinical features, laboratory test results, imaging study findings, and treatment methods were recorded. Results The annual incidence of spinal tuberculosis was stable throughout the study period. There were 284 patients, 147 women and 137 men, with a mean age of 38.2 years. The majority of the lesions involved the thoracic spine (45.3%), followed by the lumbar spine (45.0%). Multiple level skip lesions were seen in 5.6% of cases. The erythrocyte sedimentation rate was normal in 26.8% of patients. The C-reactive protein (CRP) was normal in 30.2% of patients. Type A and type O were the most common blood types. Neurological involvement was seen in 21.8% of patients. Concomitant tuberculosis of the lung was seen in 73 (25.7%). The patients with middle school education and above account for 60.4% (102/169) in rural patients and 68.7% (79/115) in urban patients. Mean time from symptom onset to diagnosis was 18.0 months (range, three days to 360 months), and there was a significant difference between the rural patients (23.0 months) and the urban patients (10.7 months) (p00.001, t 0 −3.300). Surgical treatment was performed in 233 patients (82.0%). The preferred surgical procedure was radical anterior debridement, bone grafting and internal fixation (132 patients, 46.5%). There were 13 patients (4.2%) with anti-tuberculous chemotherapy drug allergy or toxicity, streptomycin anaphylaxis and toxicity in 12, and isoniazide anaphylaxis and toxicity in one. No mortality was related to spinal TB. Conclusion The annual incidence of spinal tuberculosis remained unchanged throughout the study period and most of the patients did not pay much attention to the disease and received timely treatment. Thus, we should strengthen the census and treatment of spinal tuberculosis in Southwest China.

Clinical Characteristics and Neurologic Recovery of Patients with Cervical Spinal Tuberculosis: Should Conservative Treatment Be Preferred? A Retrospective Follow-Up Study of 115 Cases

“…In our study, patients in rural and urban areas had shorter duration of symptoms compared with what was reported by Wang et al (17) on spinal TB. CST is more severe, and it can cause intolerable discomfort or complete paralysis.…”

“…The significant difference in symptom duration between the 2 areas indicated that social and economic disparities had posed challenges to the health of people in rural areas in China. As stated in the study by Wang et al (17), people in rural areas have poor knowledge and awareness to TB and lower economic status in society. Neck pain disappeared almost immediately in patients who underwent surgery, but this was not the case the nonsurgery group, so pain control to help patients become more functional in daily activities is indispensable in the nonsurgery group.…”

“…Abbreviations and Acronyms CSM: Cervical spondylotic myelopathy CST: Cervical spinal tuberculosis ESR: Erythrocyte sedimentation rate JOA: Japanese Orthopaedic Association TB: Tuberculosis is likely to cause spinal cord compression, leading to paralysis or death (10,17). Large case studies of CST are scant in the literature, and no study has examined the predictors and the pattern of neurologic recovery after treatment.…”

One-stage combined anterior-posterior approach treatment of multiple cervicothoracic spinal tuberculosis with kyphosis

“…The annual incidence of spinal tuberculosis has remained unchanged in the southwest of China, but if not treated adequately, it may cause serious sequelae [6]. At present, there are no detailed reports about the treatment of cervicothoracic tuberculosis.…”

Research Article Correlation analysis of ADAMTS-4, VCAM-1, and TAK1 expression in cartilage tissue from spine tuberculosis.

“…The main clinical manifestations of spinal tuberculosis include spinal pain, kyphosis, abdominal mass, and spinal nerve compression (Merino et al, 2012;Wang et al, 2012). Currently, there is still a lack of consensus on a single standard mechanism for its pathogenesis.…”