title: Characteristics of patients with spinal tuberculosis: seven-year experience of a teaching hospital in Southwest China.
abstract: OBJECTIVE
  The purpose of this study was to investigate the characteristics of patients managed for spinal tuberculosis at the orthopaedics department of a teaching hospital in Chongqing, China, between 2004 and 2010.
  
  
  METHODS
  The study used a retrospective chart review. The epidemiology, clinical features, laboratory test results, imaging study findings, and treatment methods were recorded.
  
  
  RESULTS
  The annual incidence of spinal tuberculosis was stable throughout the study period. There were 284 patients, 147 women and 137 men, with a mean age of 38.2 years. The majority of the lesions involved the thoracic spine (45.3%), followed by the lumbar spine (45.0%). Multiple level skip lesions were seen in 5.6% of cases. The erythrocyte sedimentation rate was normal in 26.8% of patients. The C-reactive protein (CRP) was normal in 30.2% of patients. Type A and type O were the most common blood types. Neurological involvement was seen in 21.8% of patients. Concomitant tuberculosis of the lung was seen in 73 (25.7%). The patients with middle school education and above account for 60.4% (102/169) in rural patients and 68.7% (79/115) in urban patients. Mean time from symptom onset to diagnosis was 18.0 months (range, three days to 360 months), and there was a significant difference between the rural patients (23.0 months) and the urban patients (10.7 months) (p=0.001, t=-3.300). Surgical treatment was performed in 233 patients (82.0%). The preferred surgical procedure was radical anterior debridement, bone grafting and internal fixation (132 patients, 46.5%). There were 13 patients (4.2%) with anti-tuberculous chemotherapy drug allergy or toxicity, streptomycin anaphylaxis and toxicity in 12, and isoniazide anaphylaxis and toxicity in one. No mortality was related to spinal TB.
  
  
  CONCLUSIONS
  The annual incidence of spinal tuberculosis remained unchanged throughout the study period and most of the patients did not pay much attention to the disease and received timely treatment. Thus, we should strengthen the census and treatment of spinal tuberculosis in Southwest China.
authors.affiliation: Department of Orthopedics, Xinqiao Hospital, The Third Military Medical University, Xinqiao Street, Chongqing, 400037, People's Republic of China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Wang
authors.forename: Changqing
authors.initials: C
authors.lastname: Li
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Zhengfeng
authors.initials: Z
authors.lastname: Zhang
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D008297:Male; D009985:Orthopedics / Q000193:education; D012189:Retrospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000379:methods*; D014399:Tuberculosis, Spinal / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy
chemical_list: D000995:Antitubercular Agents