| Noncontiguous spinal tuberculosis: incidence and management. | |
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MedLine Citation:
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PMID: 19357878 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Tuberculosis (TB) has a worthy reputation as one of the great mimickers in medicine with a multitude of clinical pictures and variations. Noncontiguous spinal TB is described as atypical and case reports are published as rarities in the mainstream academic journals. The aim of the study was to asses the incidence and review of the management of non-contiguous spinal TB. We identified 16 cases of noncontiguous spinal TB from a single surgeon series of 98 patients, who were managed surgically between 2001 and 2006. These were diagnosed on whole spine MRI. This represents the largest series reported in literature to date and is higher than the expected incidence. Case notes and imaging were retrospectively reviewed in an attempt to ascertain if there were any parameters to differentiate this group from the rest of the TB spine population. Our incidence of noncontiguous spinal TB is 16.3%. There was a higher incidence of neurology in the noncontiguous group (75%) compared to the rest of our group (58.5%). Non-contiguous TB was not found to be a manifestation of HIV, MDR TB or of chronicity in our series. Most noncontiguous lesions were evident on plain radiology. Noncontiguous spinal TB is common in areas of high prevalence such as South Africa. Despite being frequently missed initially, noncontiguous involvement is evident on plain radiography and simply requires a higher index of suspicion. When investigating spine TB patients, simple radiology of the entire spine is mandatory. If available, a full spine sagittal MRI is extremely useful in identifying noncontiguous lesions. Treatment of noncontiguous tuberculosis is as for standard spinal TB cases in our unit with similar outcomes, but care needs to be taken in surgical planning as patients may have multiple areas of neurological compromise. |
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Authors:
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Peter Polley; Robert Dunn |
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Publication Detail:
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Type: Journal Article Date: 2009-04-09 |
Journal Detail:
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Title: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Volume: 18 ISSN: 1432-0932 ISO Abbreviation: Eur Spine J Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-08-27 Completed Date: 2009-12-03 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 9301980 Medline TA: Eur Spine J Country: Germany |
Other Details:
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Languages: eng Pagination: 1096-101 Citation Subset: IM |
Affiliation:
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Division of Orthopaedic Surgery, Groote Schuur Hospital, Cape Town, South Africa. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Female Humans Incidence Magnetic Resonance Imaging Male Middle Aged Retrospective Studies Spine / pathology Spondylitis / epidemiology*, pathology, therapy* Tuberculosis, Spinal / epidemiology*, pathology, therapy* Young Adult |
| Comments/Corrections | |
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