Spinal tuberculosis; Clinical presentation, medical and surgical management A prospective study on 102 patients in Basrah, South of Iraq

A longitudinal follow up study examined the clinical features, management and the outcome of treatment for patients with spinal tuberculosis.

Objectives: To analyse the cases with spinal tuberculosis in Basrah (the south of Iraq), to define the medical and surgical outcome of treatment.

Summary and background: All forms of tuberculosis are endemic disease in Basrah, the spine pathology is the commonest extra pulmonary site, the indication for surgery should be tailored to each patients, chemotherapy is mandatory for all.

Method: In this study, we received the specific questionnaire for the cases of spinal tuberculosis between December 2019 and May 2023, admitted in Basrah university teaching hospital, triple chemotherapy (Isoniazid, Rifampicin and Ethambutol) were given to all patients for six months, some had radical or conservative surgery according to patients local and general condition, the outcome was assessed and defined.

Results: A total of 102 patients were diagnosed with spinal tuberculosis, the mean age is 39.7 years The most common vertebral involvement was the dorsal region, 72 patients had severe symptoms; surgery was performed for the 72 patients with severe symptoms, while the remaining 30 patients with mild symptoms had chemotherapy only. Outcome results were as follows: 30 patients cured on conservative treatment only, 56 patients out of those who had surgery with chemotherapy (72 patients) showed good improvement in the motor and sensory function, out of them 12 patients with complete paraplegia remains in the same condition.

Conclusion: Our result showed that the early recognition of the pathology would yield very good result after conservative treatment in those without neurological deficit. The presence of neurological deficit is a good indication for surgery. Chemotherapy for six months is mandatory for all patients.