Background:Tuberculosis of the spine remains a major health problem in developing countries. Despite its prevalence there have been few reports of its presentation and prognosis in Nigeria. Objective:To review the patterns of presentation, available treatment methods and outcome of tuberculosis of the spine at our centre. Methods:A retrospective review of all patients with tuberculosis of the spine seen at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from 1st January 1999 to 31st December, 2005 was carried out. The clinical features, laboratory test results, radiologic features, treatment methods and outcome were analyzed. Results:A total of 62 patients with Tuberculosis of the spine were seen and treated during the study period out of which 49 had complete information suitable for analysis. These consisted of 24 males (49%) and 25 females (51%) with a mean age of 32.8 + SD. Students (30.6%) and traders (26.5%) were the most affected groups. Back pain (85.7%) and weakness of the lower limbs (87.7%) were the commonest presenting complaints. The most commonly involved region of the spine was the lumbar spine (49%) with 37patients (75.5%) having multiple consecutive vertebral involvement. The commonest radiographic pattern was wedge collapse of the vertebral bodies and destruction of the intervertebral disc (63.3%). Human Immunodeficiency Virus (HIV) screening was confirmed positive in 2 (7.4%) out of 27 patients that had the test. Only 24 patients (49%) had satisfactory healing with no persisting spine deformity or paraplegia. Conclusion:The incidence of tuberculosis of the spine continues to rise. The outcome of the modalities of management presently available is unsatisfactory. There is need to improve the facilities for spinal surgery so that our patients can maximally benefit from a combination of surgery and chemotherapy. Introduction Tuberculosis is an ancient infection that has plagued humans throughout recorded and archeologic history. It is still very much with us today. The infection remains the cause of a higher morbidity and mortality than any other infection in the world, especially in the densely populated developing countries1. At least 80 per cent of the approximately 3 million that die annually are in the developing countries1, 2.Tuberculosis is therefore a major health problem and it will be difficult to eradicate so long as poverty, overpopulation and malnutrition remain with us. The prevalence of tuberculosis is also rising in the industrialized world like the United States of America2. Factors that have been blamed for the rise include an increase in the number of people who have immunosuppression from HIV/AIDS and the development of drug resistant strains of mycobacteria. This rise has been associated with a concomitant rise in the number of adults and children with bone and joint tuberculosis2. In developing countries tuberculosis of the spine remains a major health problem. It is the most common and most dangerous form of musculoskeletal tuberculosis2, 3, 4, 5. Delay in establishing diagnosis and management cause spinal cord compression and spinal deformity. Tuberculosis is the most frequent cause of nontraumatic paraplegia in most parts of Africa6, 7. Early diagnosis is therefore essential to avoid its devastating complications especially paraplegia.After the early reports of spine tuberculosis in Nigeria by Konstam8 and later by Dickson9 there have been few reports on its presentation and prognosis despite its prevalence in Nigeria. The scant attention paid to this disease in the literature is potentially dangerous. Since the last report from our centre10, some diagnostic facilities like the Computerized Axial Tomography Scan have been acquired. This review has been carried out to determine if anything has changed in the presentation, available modalities of management and outcome of spine tuberculosis at our centre. Patients And Methods The records of all patients with spinal tubercul
展开▼
