title: Changes in the incidence and management of spinal tuberculosis in a French university hospital rheumatology department from 1966 to 2010.
abstract: BACKGROUND
  Two previous single-center studies in a university hospital rheumatology department suggested an increase in the incidence of spinal tuberculosis in France in the 1990s. Our objective in this study was to obtain incidence data on spinal tuberculosis since 1995 in the same department and to describe changes over the entire study period from 1966 to 2010. We also compared patients seen between 1966 and 1995 to those seen between 1995 and 2010.
  
  
  METHODS
  We conducted a retrospective review of all cases of spinal tuberculosis seen in our rheumatology department between 1966 and June 1995 and between July 1995 and 2010. We collected the annual incidence, clinical and radiological features, and diagnostic and therapeutic strategies.
  
  
  RESULTS
  One hundred and thirty patients were managed between 1966 and 2010. The number of cases declined in the 1970s and 1980s then increased over the next two decades. None of the patients had HIV infection. Over 70% of patients were from continental France. Compared to patients seen during the earlier period, those seen after June 1995 were older (62.8±17.2 vs. 53±14.3 years, P=0.0006), had more comorbidities, and more often exhibited severe radiological findings (including multilevel involvement, epidural involvement, and abscesses). No changes occurred in time to diagnosis or management strategies.
  
  
  CONCLUSIONS
  The incidence of spinal tuberculosis in a university hospital rheumatology department has increased over the last two decades, chiefly as a result of reactivation of past tuberculosis, as opposed to origin from endemic countries or HIV infection.
authors.affiliation: Service de rhumatologie, université de Lille 2, hôpital Roger-Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille cedex, France. Electronic address: cecile.wibaux@chru-lille.fr.
authors.forename: Cécile
authors.initials: C
authors.lastname: Wibaux
authors.forename: Marlyse
authors.initials: M
authors.lastname: Moafo-Tiatsop
authors.forename: Irina
authors.initials: I
authors.lastname: Andrei
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Biver
authors.forename: Anne
authors.initials: A
authors.lastname: Cotten
authors.forename: Bernard
authors.initials: B
authors.lastname: Cortet
authors.forename: Bernard
authors.initials: B
authors.lastname: Duquesnoy
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
mesh_terms: D000368:Aged; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy