Tuberculous Spondylitis, 14 Years’ Experience of a Tertiary Care Center in Saudi Arabia

• 作者: Abdulrahman Alsaedy Abdulrahman Balkhoyor Adel Alothman Hind Alhatmi Mohammad Bosaeed Sameera Aljohani Sami Aleissa
• 来源期刊: 传染病进展(英文)
• 学科: 医学
• 关键词: SPINAL TUBERCULOSIS Clinical PRESENTATION SAUDI ARABIA
• 年，卷（期）: 2018,（4）
• 页码范围: 229-240
• 页数: 12页
• 分类号: R73

摘要

Background: Spinal Tuberculosis is the most common and dangerous form of skeletal tuberculosis. It has the potential for serious morbidity, including permanent neurologic deficits and severe deformity. The aim of this study is to review spinal Tuberculosis (TB) cases in our tertiary care center and evaluate it from different aspects, which may provide great support to the clinical decisions of this disease. Methods: The study was a retrospective charts review of all adult spinal TB patients who were evaluated at King Abdulaziz Medical City, Riyadh, from January 2001 to March 2015. The inclusion of cases will need to meet a specific case definition. Patients demography, presenting symptoms and signs, and radiological and microbiological data for all the patients were collected and reviewed. Results: A total of 61 cases screened charts were included according to the case definition. 59% were female, and the mean age was 51.3 years. The most presenting symptom was back pain (85%), followed by lower limbs weakness and lower limbs pain. The average duration of symptoms was 170 days. The average hospital stay was 41.4 days. On physical examination, about half of the patients had bilateral lower limbs weakness. Acute phase reactants like C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) were elevated, 97% and 92% respectively, however leukocytosis was not common. Out of all the patients who had a biopsy done (59 patients), 51 patients (86%) had positive AFB culture. MTB PCR was done from spine biopsy in 16 patients, and 81% were positive. Out of 53 tissue specimens, histopathology showed 45% necrotizing granuloma, 21% non-necrotizing granuloma, and 34% non-specific inflammation. Imaging (either CT scan or MRI) was performed on the patients at the time of presentation, and the most common signs seen in both were vertebral bone destruction (95%, 80%) and perivertebral collections (70%, 84%). The thoracic and lumbar vertebrae were the most common involved locations. Thirty-one patients had both modalities d