Abstract
Spinal tuberculosis (TB), the most common form of musculoskeletal tuberculosis, is an infection-related disease globally, with paraplegia occurring in severe cases. Therefore, identification of spinal TB at an early stage is important for early intervention and eventual therapy. In this study, we conducted a prospective cohort study in routine clinical practice to investigate the diagnosis of different TB tests. A total of 519 patients were recruited based on the radiology of spinal TB. The diagnostic model was computed by regression analysis and was determined by receiver operating characteristic (ROC) curve analysis. Specificity, sensitivity, predictive value, likelihood ratio, and accuracy were also computed and compared. GeneXpert MTB/RIF showed a higher positive rate compared to that in the acid-fast bacilli smear and Mycobacterium culture. The results also showed that the Mycobacterium tuberculosis-specific antigen/phytohemagglutinin ratio in the T-SPOT assay had a good performance in the preoperative diagnosis and prediction of spinal TB. The diagnostic model based on the ratio of tuberculosis-specific antigen/phytohemagglutinin combined with GeneXpert MTB/RIF showed better efficiency for spinal TB diagnosis. In summary, the tuberculosis-specific antigen/phytohemagglutinin ratio combined with GeneXpert MTB/RIF could provide an early diagnosis of spinal TB.
Highlights
Tuberculosis (TB) is a kind of bacterial communicable disease caused by the Mycobacterium tuberculosis (MTB) complex (Furin et al, 2019)
Our results collectively suggested that the that MTB-specific antigen (TBAg)/PHA ratio of the ELISpot (T-SPOT) assay combined with other methods could be used to establish a differential model for the differentiation of spinal TB from other spinal diseases
We proved that the TBAg/PHA ratio showed a better capability to distinguish spinal TB from NTB, especially when used combined with GeneXpert MTB/RIF
Summary
Tuberculosis (TB) is a kind of bacterial communicable disease caused by the Mycobacterium tuberculosis (MTB) complex (Furin et al, 2019). Spinal TB is a common spine infection disease, usually caused by lymphohematogenous spread from a pulmonary TB and occasionally by genitourinary system TB spread via venous or arterial routes in some cases (Ryu and Patel, 2015; Dunn and Ben Husien, 2018). Spinal TB is prevalent in children and young adults, usually during the initial latent phase of the infection (Ryu and Patel, 2015; Dunn and Ben Husien, 2018). Spinal TB is frequently asymptomatic in its early stage. Early diagnosis of spinal TB is crucial for preventing the disease and improving therapeutic effects
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