Spinal Tuberculosis Presentations Among Adults: Findings From a Federal Tertiary Health Facility in South-East Nigeria

Abstract

Tuberculosis, an antique disease with modern relevance, continues to increase in prevalence. Spinal tuberculosis is a common extrapulmonary form of the disease. We retrospectively studied adult (≥18years) patients diagnosed with Pott’s disease at the Federal Medical Centre, Owerri between January 2015 and December 2019. Their demographic data, clinical profiles and outcomes are reported. A total of 18 patients were studied comprising an equal number of males and females with an age range of 20 to 64 years and a mean (standard error of the mean) age of 38.5 ± 4.4 years. Majority (38.9%, n=7) of the participants were students. Two-thirds of the patients had spinal disease only and in the one-third with combined pulmonary and spinal disease, chest radiograph demonstrated radiographic features of pulmonary tuberculosis. A gibbus was present in 5 (27.8%) of the patients and the commonest radiographic abnormality was lumbar collapse (76.9%, n=10). The mean (SEM) erythrocyte sedimentation rate of the patients was 81 ± 28.9 mm/1^st hr Westergren. All patients underwent a 12-month combination therapy (regimen 2 months of isoniazid, rifampicin, pyrazinamide and ethambutol/10 months of isoniazid and rifampicin) with good outcomes. Spinal tuberculosis remains a prevalent presentation of tuberculosis in the developing world and poses a serious risk of neurological sequelae if detected and/or treated late. A high index of suspicion alongside early diagnosis, initiation and completion of treatment are imperative to achieving good outcomes.