Spinal Tuberculosis among Yemeni Patients Admitted to Two Major Hospitals in Sana’a: A Neurosurgey Experience

Abstract

Objective: To analyze the outcomes of neurosurgical treatment of dorsal spinal tuberculosis (TB) among Yemeni patients.
 Methods: Forty-three patients with histopathology-confirmed dorsal spinal TB, who had been admitted to Kuwait University Hospital of Sana’a University and the University of Science and Technology Hospital, Sana’a, were followed up for the outcomes of neurosurgical treatment in the period from Ott. 2009 to Oct. 2005. Data about the clinical presentation, radiologic findings and the outcomes of surgical treatment were recorded and analyzed.
 Results: Of patients undergoing neurosurgical treatment of dorsal spinal TB, 28 were males and 15 were females, with a mean age of 41.3 years (range: 18–70). Nearly a half of patients (50.6%) were farmers and 80% of patients were admitted to hospitals three months after the disease onset. All patients presented with back pain, while paraplegia/paraparesis and sensory impairment were reported in 81.4% and 87.4% of patients at presentation, respectively. Four patients (9.2 %) had cold abscesses and were treated by abscess drainage, while 90.8% of patients were treated by surgical decompression, debridement and posterior transpedicular fixation by screws and rods.
 Conclusions: The posterior approach for the treatment of spinal TB, with bilateral transpedicular access to anterior decompression together with posterior transpedicular fixation, has satisfactory outcomes regarding the clinical improvement and spinal stabilization among Yemeni patients.