SPINAL TUBERCULOSIS REVISTED : STUDY OF CLINICALPRESENTATION, DIAGNOSIS, AND MANAGEMENT OF SPINAL TUBERCULOSIS IN A TERTIARY CARE CENTRE IN SOUTH INDIA

Abstract

Introduction: Tuberculosis is a disease that affects mostly young individuals in their productive formative years. The risk is 20–37 times greater in HIV co- infected individuals than among those without HIV. Spinal tuberculosis is uncommon in the western world as compared to Asian countries. But it is e-emerging in Western Countries due to the HIV pandemic. Aim Of The Study: This study analysis the clinical presentation, neuroradiology manifestations, and treatment aspects of spinal tuberculosis. Design: Observational study. Materials And Methods: Patients admitted in government Royapettah hospital during the year July 2018- February 2020 in the general medical ward with the diagnosis of paraplegia / paraparesis and subsequently diagnosed with spinal tuberculosis were recruited for the study. 35 of them were diagnosed to have spinal tuberculosis after Inclusion and exclusion criteria. Detailed history was taken, examination was done and appropriate imaging (MRI Spine, CT Chest) was taken. Results: 1 (2.9 %) patient had intramedullary lesion in the form of longitudinally extensive transverse myelitis. 34 (97.1 %) patients had extra medullary lesion. 26 (74.3 %) patients underwent medical management. All of them were started on CAT I ATT DOTS regimen along with steroids. 9 (25.7 %) of them underwent both surgical and medical management. Conclusion: The prime aim of treatment of spinal tuberculosis is prevention of deformity so that patients can have a better quality of life. Paramount to this is a high index of suspicion, early detection and initiation of treatment. A holistic treatment approach in all cases of spinal tuberculosis is needed to prevent this dreaded complication.