New Risk Factor for Neurological Involvement in Patient with Spinal Tuberculosis

Abstract

Background : Spinal tuberculosis is one of the causes leading to damage to the spine, nerve roots, or spinal cord. Few studies have identified the risk factors of developing neurological deterioration in spinal tuberculosis patients. In order to take care of the patients promptly before developing paralysis, the risk factors of neurological deterioration in these patients should be identified.

Methods:  The demographics and clinical characteristics of the patients diagnosed with spinal tuberculosis at Srinagarind hospital between 1993 and 2013 were collected. These include; age, sex, local pain and tenderness, radicular pain, body temperature, bladder involvement, Cobb angle, neurological deficit, vertebral collapse, endplate collapse, signal cord change, posterior element involvement, paraspinal or epidural abscess, disk space involvement, levels of involvement, ESR, and CRP. Univariate analyses were used to identify individual risk factors. Multivariate analyses were used to adjust the effect of combined risk factors.

Result: A total of 125 patients with spinal tuberculosis were categorized into two groups of 70 men aged around 55.7 (55.7± 2.0 years) and 55 women aged around (52.3± 2.4 years). According to univariate analysis, the risk factors for developing neurological deterioration were signal cord changes, Cobb (>30 degrees), radicular pain, and epidural abscess. Multivariate analyses found that the only one risk factor for developing neurological deterioration was signal cord change.

Conclusion: The risk factor for developing neurological deterioration in spinal tuberculosis patients was signal cord change.