Postoperative Neurological Outcome in Spinal Tuberculosis Patients Presenting with Severe Neurological Deficits

Abstract

Objective: To determine the postoperative neurological outcome in spinal tuberculosis patients presenting with severe neurological deficits. Materials and Methods: 57 patients of 22 to 65 years of spinal tuberculosis were included in this study from January 2018 to March 2023. Data was collected from the hospital records of the patients who were admitted and operated on for tuberculosis of the spine. All regions of the spine were taken for study. ASIA scoring was done and patients were labeled from ASIA scores A to E. All patients were operated and postoperative ASIA scoring was also done on follow-up visits. An Independent sample t-test was used to assess the difference in the mean of these variables. Results: The mean age was 44.45 ± 8.54 years. Males were 39 and females 18. Preoperatively 27 patients had ASIA B, 28 patients had ASIA C and 02 patients had ASIA D score. All these patients improved postoperatively. The mean preoperative ASIA Score was 2.03 ± 2.4 and the mean postoperative ASIA score was 4.1 ± 1.3 withp-value of 0.02. Patients having old age, who present late and with poor grades in neurology had worse outcomes postoperatively. Conclusion: Patients with spinal tuberculosis presenting even with severe neurological deficits had significant improvement in neurology postoperatively. Keywords: Spinal tuberculosis (TB), American Spinal Injury Impairment Score (ASIA), Mycobacterium Tuberculosis, Potts disease, Trans-pedicular decompression and fusion, Laminectomy, Magnetic resonance imaging (MRI).