Predictive factors for neurological deficit in patients with spinal tuberculosis

• Main Authors: Surachai Sae-Jung, Nattamon Wongba, Kriwut Leurmprasert
• Format: Article
• Language: English
• Published: SAGE Publishing 2019-08-01
• Series: Journal of Orthopaedic Surgery
• Online Access: https://doi.org/10.1177/2309499019868813

Background: Spinal tuberculosis (TB) is a leading cause of damage to the spine and associated neural structures. Purpose: This study aims to identify the risk factors for neurological deterioration in spinal TB patients to promptly care for the patients before paralysis develops. Methods: The demographics, clinical characteristics, laboratory results, and radiographic findings of spinal TB patients were collected between 1993 and 2016. The data were analyzed using logistic regression methods. The predictive factors for neurological deficit were identified. Results: There were 125 spinal TB patients (70 men and 55 women). The average age ± standard deviation was 55.7 ± 2.0 and 52.3 ± 2.4=years, respectively. According to the univariate analysis, the significant risk factors associated with neurological deterioration were signal cord changes, notable Cobb angle (>30°), radiating pain, and epidural abscess. The multivariate analysis revealed that only signal cord change and notable Cobb angle significantly influenced neurological status. Conclusion: The predictive factors for neurological deterioration in spinal TB patients are signal cord change and notable Cobb angle. Surgery should be considered in patients who present with these factors before the development of neurological deterioration.