CLINICAL AND RADIOLOGICAL EVALUATION OF SPINAL TUBERCULOSIS
Main Article Content
Keywords
Spinal tuberculosis, diagnosis, MRI, anti-tubercular therapy, surgical intervention
Abstract
Introduction: The tubercular spine is an extrapulmonary variant of tuberculosis and is frequently associated with severe disabling paraparesis, quadriplegia, and spinal deformities due to vertebral destruction. Hence, early diagnosis and management plays a deciding factor in improving the prognosis.
Objectives: To compare and contrast the clinical and radiological presentation of spinal tuberculosis, to compare and test diagnostic techniques and approaches to treatment of this condition.
Materials and Methods: The present study is a cross-sectional descriptive study that included 150 spinal tuberculosis patients who attended PIMS Islamabad, Pakistan and Hayatabad Medical Complex Peshawar, Pakistan. Information was obtained from a review of clinical charts and reports, symptoms, topographical abnormalities identified by X-ray and MRI scans, and outcomes. The study is done over 12 months.
Results: More than half of the patients were male (58%), with an average age of 43.2 years. Some of the symptoms the patients presented were back pain = 90%, fever = 78% and neurological deficits = 47%. MRI was the most helpful modality in diagnosing the affliction, and 20 percent needed surgery for complicated cases.
Conclusion: Tuberculosis of the spine is still a considerable concern to the public health. It is very crucial to diagnose the case early and treat it as soon as possible to enhance both medical and neurological outcomes.
References
2. Shetty, A.P., Viswanathan, V.K. and Rajasekaran, S., 2021. Cervical spine TB–Current concepts in management. Journal of Orthopaedic Surgery, 29(1_suppl), p.23094990211006936.
3. Xiang, Y., Huang, C., He, Y. and Zhang, Q., 2021. Cancer or tuberculosis: a comprehensive review of the clinical and imaging features in diagnosis of the confusing mass. Frontiers in Oncology, 11, p.644150.
4. Jain, V.K., Iyengar, K.P., Botchu, R. and Vaishya, R., 2022. Sacroiliac joint tuberculosis revisited–A clinico-radiological review. Journal of Clinical Orthopaedics and Trauma, 24, p.101707.
5. Karthek, V., Bhilare, P., Hadgaonkar, S., Kothari, A., Shyam, A., Sancheti, P. and Aiyer, S.N., 2021. Gene Xpert/MTB RIF assay for spinal tuberculosis-sensitivity, specificity and clinical utility. Journal of Clinical Orthopaedics and Trauma, 16, pp.233-238.
6. Irede, E.L., Aworinde, O.R., Lekan, O.K., Amienghemhen, O.D., Okonkwo, T.P., Onivefu, A.P. and Ifijen, I.H., 2024. Medical imaging: a critical review on X-ray imaging for the detection of infection. Biomedical Materials & Devices, pp.1-45.
7. Wu, H., Cui, Y., Gong, L., Liu, J., Fan, Y., Zhou, Y. and Li, W., 2022. Comparison between single anterior and single posterior approaches of debridement interbody fusion and fixation for the treatment of mono-segment lumbar spine tuberculosis. Archives of Orthopaedic and Trauma Surgery, 142(12), pp.3643-3649.
8. Caetano, A.P., Mascarenhas, V.V. and Machado, P.M., 2021. Axial spondyloarthritis: mimics and pitfalls of imaging assessment. Frontiers in Medicine, 8, p.658538.
9. Shen, J., Zheng, Q., Wang, Y. and Ying, X., 2021. One-stage combined anterior-posterior surgery for thoracic and lumbar spinal tuberculosis. The journal of spinal cord medicine, 44(1), pp.54-61.
10. Gupta, N., Kadavigere, R., Malla, S., Bhat, S.N. and Saravu, K., 2023. Differentiating tubercular from pyogenic causes of spine involvement on Magnetic Resonance Imaging. Le Infezioni in Medicina, 31(1), p.62.
11. Gopalaswamy, R., Dusthackeer, V.A., Kannayan, S. and Subbian, S., 2021. Extrapulmonary tuberculosis—an update on the diagnosis, treatment and drug resistance. Journal of Respiration, 1(2), pp.141-164.
12. Ahuja, K., Gupta, T., Ifthekar, S., Mittal, S., Yadav, G. and Kandwal, P., 2021. Variability in management practices and surgical decision making in spinal tuberculosis: an expert survey-based study. Asian Spine Journal, 16(1), p.9.
13. Alsaffar, M., Alshammari, G., Alshammari, A., Aljaloud, S., Almurayziq, T.S., Hamad, A.A., Kumar, V. and Belay, A., 2021. Detection of tuberculosis disease using image processing technique. Mobile Information Systems, 2021(1), p.7424836.
14. Salaffi, F., Ceccarelli, L., Carotti, M., Di Carlo, M., Polonara, G., Facchini, G., Golfieri, R. and Giovagnoni, A., 2021. Differentiation between infectious spondylodiscitis versus inflammatory or degenerative spinal changes: How can magnetic resonance imaging help the clinician?. La radiologia medica, 126(6), pp.843-859.
15. Jaimni, V., Shasty, B.A., Madhyastha, S.P., Shetty, G.V., Acharya, R.V., Bekur, R. and Doddamani, A., 2021. Association of vitamin D deficiency and newly diagnosed pulmonary tuberculosis. Pulmonary medicine, 2021(1), p.5285841.
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Dr Ibrar Ali
Medical Officer, Orthopaedic and Spine Surgeon Trauma Unit, Qazi Hussain Ahmed Medical Complex MTI Nowshera, Pakistan
Dr Muhammad Bilal khan
Specialist Registrar Orthopaedic, Accident and Emergency, Hayatabad Medical Complex Peshawar, Pakistan
Dr Abdul Qadir Khan
Assistant Professor Orthopaedic, PIMS Islamabad, Pakistan
Dr Abdus Saboor Awan
District Orthopaedic Surgeon, DHQ Hospital Haripur, Pakistan
Dr Inamullah Khan
Orthopaedic Surgeon, DHQ Hospital Haripur, Pakistan