Abstract
The objective of this study was to investigate the treatment and prognosis of patients with spinal tuberculosis in Guizhou province. A total of 863 patients with spinal tuberculosis admitted to our hospital from 2006 to 2017 were included in this study. All patients underwent standardized quadruple antituberculosis treatment. Eighty patients were lost to follow-up due to a change of their contact information or noncompliance. A total of 783 patients completed the follow-up. The average follow-up period was 20.33 ± 8.77 months (range: 6 to 38 months). Among these patients, 145 patients underwent conservative treatment, while 638 patients underwent surgical treatment. All patients in the surgery group were treated with lesion removal, bone graft fusion, and internal fixation. Preoperative and postoperative standard quadruple antituberculosis treatment was administered. The clinical efficacy was evaluated according to erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), visual analogue scale (VAS), Cobb angle correction, neurological functional recovery, and interbody fusion with bone graft and tuberculosis outcome. A total of 608 patients achieved clinical cure. The symptoms, physical signs, blood tests and imaging findings were improved in 143 patients. Twenty patients showed refractory clinical symptoms, and 12 patients had local tuberculosis recurrence. Conservative and surgical treatments are the mainstream treatments for spinal tuberculosis. According to the patients' individual conditions, individualized treatments should be used to achieve good efficacy. Standardized antituberculosis treatment should be applied over the course of spinal tuberculosis.
Highlights
China is a region with a higher incidence of tuberculosis and ranks second worldwide in the total number of patients with tuberculosis
A total of 863 patients with spinal tuberculosis who were admitted to our hospital from 2006 to 2017 were included in this study
In our analysis of 783 bacteriologically/histopathologically confirmed cases of spinal tuberculosis, 677 (86.5%) patients had a typical magnetic resonance imaging (MRI) picture
Summary
China is a region with a higher incidence of tuberculosis and ranks second worldwide in the total number of patients with tuberculosis. In 2012, Erdem H reported that TB ranks second, just after HIV infection, among infectious causes of mortality [2]. There are a large number of people suffering from pulmonary tuberculosis and extrapulmonary tuberculosis [3]. Osteoarticular tuberculosis is a common secondary extrapulmonary tuberculosis, of which spinal tuberculosis accounts for 50%. Spinal tuberculosis is common in young adults, responsible for kyphosis and paraplegia, associated with a high disability rate and difficult to treat. Spinal tuberculosis mainly infects weight-bearing joints with frequent movement. Thoracic (40% to 50%), lumbar (35% to 45%), and cervical (10%) vertebrae are common sites for infection [4]. Tuberculosis patients with definite surgical indications should receive standardized antituberculosis therapy and undergo lesion removal, bone graft fusion and internal fixation [5]
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