Spinal tuberculosis; A study of the disease pattern, diagnosis and outcome of medical management in Sri Lanka.

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dc.contributor.authorYasaratne, B M G D
dc.contributor.authorWijesinghe, S N R
dc.contributor.authorMadegedara, R M D
dc.date.accessioned2015-07-17T11:19:12Z
dc.date.available2015-07-17T11:19:12Z
dc.date.issued2013-10
dc.description.abstractBackground: Sri Lanka has an intermediate burden of tuberculous disease. Most patients with spinal tuberculosis (STB) are managed with medical treatment alone as advanced surgical facilities are not freely available. Objective: To describe the clinico-demographic and imaging pattern of STB and to assess the outcome of medical treatment in the local setting. Design: Descriptive case series. Methods: All patients diagnosed with definite or probable STB, had their symptomatology and investigations recorded. They were followed up with anti-TB treatment (ATT) according to standard guidelines. An initial six-week tapering course of steroid was given when there was an evidence of neural involvement. Results: Of 32 patients with STB, backache was the commonest presenting feature (92%). Nine had lower limb neurological deficits. Uni-focal upper lumbar involvement was the commonest disease pattern noted in the series. High ESR (84%) and Mantoux positivity (53%) were frequent. 72% had end-plate changes on imaging. 53% had paraspinal soft tissue components. The triad of backache, high ESR and end-plate and/or paraspinal disease on CT/MRI showed a diagnostic sensitivity of 81.2%. Response to ATT was satisfactory in 87%. Poor neurological response was seen among some with large paraspinal collections or extensive vertebral damage at diagnosis. Conclusion: This study showed that backache over one month, high ESR and specific CT/MRI features helped diagnosis of STB, in the absence of definitive evidence. Medical management alone, comprising a prolonged course of ATT with an initial steroid cover when indicated, appeared to be safe and effective in the local setting for uncomplicated STB.en_US
dc.identifier.citationYasaratne B M G D, Wijesinghe S N R, Madegedara R M D. Spinal tuberculosis; A study of the disease pattern, diagnosis and outcome of medical management in Sri Lanka. Indian Journal of Tuberculosis. 2013 Oct; 60(4): 208-216.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/159972
dc.language.isoenen_US
dc.source.urihttps://medind.nic.in/ibr/t13/i4/ibrt13i4p208.pdfen_US
dc.subjectTuberculous spondylitisen_US
dc.subjectPott’s diseaseen_US
dc.subjectOutcomeen_US
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshChild
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshSri Lanka --epidemiology
dc.subject.meshTreatment Outcome
dc.subject.meshTuberculosis, Spinal --diagnosis
dc.subject.meshTuberculosis, Spinal --epidemiology
dc.subject.meshTuberculosis, Spinal --therapy
dc.subject.meshYoung Adult
dc.titleSpinal tuberculosis; A study of the disease pattern, diagnosis and outcome of medical management in Sri Lanka.en_US
dc.typeArticleen_US
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