Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes

INTRODUCTION: Tuberculosis is still endemic in Tunisia. Among musculoskeletal involvement, spinal tuberculosis (STB) or «Pott’s Disease» is the most common and can lead to serious neurological complications. The purpose of our study was to focus on STB features (clinical, biological, and radiologica...

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Autores principales: Boussaid, Soumaya, M’rabet, Mariem, Rekik, Sonia, Jammali, Samia, Rahmouni, Safa, Zouaoui, Khaoula, Sahli, Hela, Elleuch, Mohamed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Mediterranean Journal of Rheumatology (MJR) 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10466368/
https://www.ncbi.nlm.nih.gov/pubmed/37654630
http://dx.doi.org/10.31138/mjr.34.2.220
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author Boussaid, Soumaya
M’rabet, Mariem
Rekik, Sonia
Jammali, Samia
Rahmouni, Safa
Zouaoui, Khaoula
Sahli, Hela
Elleuch, Mohamed
author_facet Boussaid, Soumaya
M’rabet, Mariem
Rekik, Sonia
Jammali, Samia
Rahmouni, Safa
Zouaoui, Khaoula
Sahli, Hela
Elleuch, Mohamed
author_sort Boussaid, Soumaya
collection PubMed
description INTRODUCTION: Tuberculosis is still endemic in Tunisia. Among musculoskeletal involvement, spinal tuberculosis (STB) or «Pott’s Disease» is the most common and can lead to serious neurological complications. The purpose of our study was to focus on STB features (clinical, biological, and radiological) and to identify factors associated with early unfavorable outcomes. METHODS: This was a monocentric retrospective study, over a period of 20 years (2000–2020). Only patients treated appropriately were included. Patients’ informations were noted. We defined the favorable outcome criterion as weight gain, apyrexia, improvement of the general state, relief of pain, improvement in the classic inflammatory markers (CRP), and absence of vertebral deformities, neurological impairment, or sepsis. The outcome was considered unfavorable otherwise. RESULTS: Our study involved 52 patients. Their average age was 55.21 years±17.79. The average symptom duration was 8.9 months±6.54. Spinal pain was the most common functional sign (90.4%) often inflammatory. Physical signs were dominated by segmental spinal stiffness (71.2%). Spinal magnetic resonance imaging was performed in 38 patients. The disco-vertebral biopsy puncture confirmed the diagnosis in 15 cases. All patients received anti-tuberculosis treatments with an average duration of 10.02±1.97months. The outcome at one month of follow-up was favorable in 32 cases. Poor prognosis factors were normochromic normocytic anaemia (p=0.018), initial lymphocytosis (p=0.048), and fever (p=0.01). However, vertebral fracture at standard X-ray was predictive of favorable outcome (p=0.001). CONCLUSION: STB is a frequent condition that needs to be treated rapidly. Poor prognosis factors were identified in this study such as normocytic normochromic anemia, initial lymphocytosis, and fever at baseline.
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spelling pubmed-104663682023-08-31 Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes Boussaid, Soumaya M’rabet, Mariem Rekik, Sonia Jammali, Samia Rahmouni, Safa Zouaoui, Khaoula Sahli, Hela Elleuch, Mohamed Mediterr J Rheumatol Original Paper INTRODUCTION: Tuberculosis is still endemic in Tunisia. Among musculoskeletal involvement, spinal tuberculosis (STB) or «Pott’s Disease» is the most common and can lead to serious neurological complications. The purpose of our study was to focus on STB features (clinical, biological, and radiological) and to identify factors associated with early unfavorable outcomes. METHODS: This was a monocentric retrospective study, over a period of 20 years (2000–2020). Only patients treated appropriately were included. Patients’ informations were noted. We defined the favorable outcome criterion as weight gain, apyrexia, improvement of the general state, relief of pain, improvement in the classic inflammatory markers (CRP), and absence of vertebral deformities, neurological impairment, or sepsis. The outcome was considered unfavorable otherwise. RESULTS: Our study involved 52 patients. Their average age was 55.21 years±17.79. The average symptom duration was 8.9 months±6.54. Spinal pain was the most common functional sign (90.4%) often inflammatory. Physical signs were dominated by segmental spinal stiffness (71.2%). Spinal magnetic resonance imaging was performed in 38 patients. The disco-vertebral biopsy puncture confirmed the diagnosis in 15 cases. All patients received anti-tuberculosis treatments with an average duration of 10.02±1.97months. The outcome at one month of follow-up was favorable in 32 cases. Poor prognosis factors were normochromic normocytic anaemia (p=0.018), initial lymphocytosis (p=0.048), and fever (p=0.01). However, vertebral fracture at standard X-ray was predictive of favorable outcome (p=0.001). CONCLUSION: STB is a frequent condition that needs to be treated rapidly. Poor prognosis factors were identified in this study such as normocytic normochromic anemia, initial lymphocytosis, and fever at baseline. The Mediterranean Journal of Rheumatology (MJR) 2023-06-30 /pmc/articles/PMC10466368/ /pubmed/37654630 http://dx.doi.org/10.31138/mjr.34.2.220 Text en © 2023 The Mediterranean Journal of Rheumatology (MJR) https://creativecommons.org/licenses/by/4.0/This work is licensed under and Creative Commons Attribution-NonCommercial 4.0 International License.
spellingShingle Original Paper
Boussaid, Soumaya
M’rabet, Mariem
Rekik, Sonia
Jammali, Samia
Rahmouni, Safa
Zouaoui, Khaoula
Sahli, Hela
Elleuch, Mohamed
Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes
title Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes
title_full Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes
title_fullStr Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes
title_full_unstemmed Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes
title_short Spinal Tuberculosis: Features and Early Predictive Factors of Poor Outcomes
title_sort spinal tuberculosis: features and early predictive factors of poor outcomes
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10466368/
https://www.ncbi.nlm.nih.gov/pubmed/37654630
http://dx.doi.org/10.31138/mjr.34.2.220
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