Early diagnosis of spinal tuberculosis

Chen, Chang Hua; Chen, Yu Min; Lee, Chih Wei; Chang, Yu-Jun; Cheng, Chun Yuan; Hung, Jui Kuo

doi:10.1016/j.jfma.2016.07.001

Cited by 82 publications

(96 citation statements)

References 65 publications

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“…Regarding the cases who underwent for both modalities, spinal compression, intravertebral collection, and disc space involvement are better recognized by MRI than CT scan with significant P values. Future research questions need to emphasizeon early identification of Tuberculous Spondylitis and differentiating it from other inflammatory and degenerative spinal diseases [29]. Access of ambulatory patients with suspected spinal pain to MRI or CT scan can be delayed for months.…”

Section: Resultsmentioning

confidence: 99%

Tuberculous Spondylitis, 14 Years’ Experience of a Tertiary Care Center in Saudi Arabia

Balkhoyor¹,

Alhatmi²,

Bosaeed³

et al. 2018

AID

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Background: Spinal Tuberculosis is the most common and dangerous form of skeletal tuberculosis. It has the potential for serious morbidity, including permanent neurologic deficits and severe deformity. The aim of this study is to review spinal Tuberculosis (TB) cases in our tertiary care center and evaluate it from different aspects, which may provide great support to the clinical decisions of this disease. Methods: The study was a retrospective charts review of all adult spinal TB patients who were evaluated at King Abdulaziz Medical City, Riyadh, from January 2001 to March 2015. The inclusion of cases will need to meet a specific case definition. Patients demography, presenting symptoms and signs, and radiological and microbiological data for all the patients were collected and reviewed. Results: A total of 61 cases screened charts were included according to the case definition. 59% were female, and the mean age was 51.3 years. The most presenting symptom was back pain (85%), followed by lower limbs weakness and lower limbs pain. The average duration of symptoms was 170 days. The average hospital stay was 41.4 days. On physical examination, about half of the patients had bilateral lower limbs weakness. Acute phase reactants like C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were elevated, 97% and 92% respectively, however leukocytosis was not common. Out of all the patients who had a biopsy done (59 patients), 51 patients (86%) had positive AFB culture. MTB PCR was done from spine biopsy in 16 patients, and 81% were positive. Out of 53 tissue specimens, histopathology showed 45% necrotizing granuloma, 21% non-necrotizing granuloma, and 34% non-specific inflammation. Imaging (either CT scan or MRI) was performed on the patients at the time of presentation, and the most common signs seen in both were vertebral bone destruction (95%, 80%) and perivertebral collections (70%, 84%

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Section: Resultsmentioning

confidence: 99%

Tuberculous Spondylitis, 14 Years’ Experience of a Tertiary Care Center in Saudi Arabia

Balkhoyor¹,

Alhatmi²,

Bosaeed³

et al. 2018

AID

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“…Symptoms are usually insidious, there may be complaints that have been going on for years before diagnosis (1) . Low back pain, fever, weight loss, and night sweats are the most common symptoms (10) . The diagnosis usually can be made on the basis of predisposing factors, history of TB disease, clinical findings and imaging methods (1) .…”

Section: Diagnosismentioning

confidence: 99%

Current Concepts on Spinal Tuberculosis

Öztürk¹,

Yener²,

Işikgöz³

2020

jtss

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Spinal tuberculosis (TB) is seen in 2% of TB patients and 50% of skeletal involvement of TB. Low back pain, fever, weight loss, and night sweats are the most common symptoms. However, the gold standard for its diagnosis is the growth of Mycobacterium tuberculosis in culture taken from tissue samples. Magnetic resonance imaging is the preferred imaging modality in the diagnosis of spinal TB. Typical findings include lesions in the vertebral endplates, anterior involvement of the vertebral body, and subligamentous spread. The aim of the treatment is to confirm the diagnosis, to clear the lesion from bacteria, and to eliminate spinal deformity and spinal cord pressure. Drug therapy is recommended for 9-12 months. There is controversy in the literature regarding the need for additional surgical intervention in the treatment of spinal TB. Many authors have suggested surgery in the presence of progressive neurological deficit, instability, progressive kyphosis above the 50 degrees or disease unresponsive to drug therapy. Surgical approach in spinal TB surgery is still being discussed. The location of the lesion, instability, patient-related factors, and severity of deformity should be considered when deciding on the approach.

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“…although studies by Chen et al [14] and Kandala et al [15] showed a male preponderance. In the present study, the mean age of HIV-positive patients with spinal TB was 47 years, and the mean age of HIV-negative patients was 35 years.…”

mentioning

confidence: 93%

Assessment of Clinical and Radiological Parameters in Spinal Tuberculosis: Comparison between Human Immunodeficiency Virus-Positive and Human Immunodeficiency Virus-Negative Patients

et al. 2020

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Prospective comparative study. purpose: A prospective comparative analysis of 30 patients with spinal tuberculosis (15 human immunodeficiency viruses [HIV] positive and 15 HIV negative). We compared the clinical and radiological parameters of the two groups. Overview of Literature: With the increasing incidence of HIV and tuberculosis co-infection, spinal tuberculosis is increasing globally, especially in developing countries. The diagnosis of spinal tuberculosis presents a challenge due to nonspecific constitutional symptoms and late presentation. Methods: A prospective study was conducted of 30 patients with spinal tuberculosis (15 HIV positive and 15 HIV negative) from August 2014-July 2016 for assessment of clinical and radiological parameters. Neurological assessment was done by classification of tuberculous paraplegia, and the amount of kyphosis was assessed by Cobb angle on a plain radiograph. Abscess size in anterior epidural space, the number of vertebral bodies involved and collapsed, and skip lesions were noted on magnetic resonance imaging. Results: In the prospective analysis of 30 patients, HIV positive (n=15) and HIV negative (n=15), there was no significant difference in neurological grading between the two groups. The amount of vertebral body destruction and degree of kyphosis was significantly greater in HIV-negative patients as compared with HIV-positive patients. There was a significant difference in Cobb angle between the two groups. The amount of anterior epidural space abscess formation was greater in HIV-positive patients as compared with HIVnegative patients. Conclusions: HIV-negative patients had greater vertebral body destruction and resultant kyphosis as compared with HIV-positive patients, who had greater anterior epidural abscess formation.

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Early diagnosis of spinal tuberculosis

Cited by 82 publications

References 65 publications

Tuberculous Spondylitis, 14 Years’ Experience of a Tertiary Care Center in Saudi Arabia

Tuberculous Spondylitis, 14 Years’ Experience of a Tertiary Care Center in Saudi Arabia

Current Concepts on Spinal Tuberculosis

Assessment of Clinical and Radiological Parameters in Spinal Tuberculosis: Comparison between Human Immunodeficiency Virus-Positive and Human Immunodeficiency Virus-Negative Patients

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