title: Outcome assessment in conservatively managed patients with cervical spine tuberculosis.
abstract: METHODS
  Cervical spine tuberculosis is a relatively less frequent form of spinal tuberculosis. Cervical spine tuberculosis has a greater propensity to involve the spinal cord and results in major sensory motor deficit. In this prospective study, we aimed to evaluate the clinical and imaging predictors of outcome in conservatively managed patients.
  
  
  METHODS
  In this study, 42 patients of cervical spine tuberculosis were included. Patients were subjected to a detailed clinical evaluation and magnetic resonance imaging. Patients were treated with antituberculosis treatment and were followed up for 18 months. The Modified Barthel index (MBI) was used to assess the disability. Good outcome was defined as MBI >12 and poor outcome as MBI ⩽12. Clinical and imaging characteristics were used to analyze the predictors of outcome, using univariate and multivariate analysis.
  
  
  RESULTS
  Four (9.5%) patients required surgery. Data from 38 patients, who were conservatively managed, were analyzed for predictors of outcome. Among conservatively managed patients, at presentation, 29 patients had an MBI score of ⩽12. At 18 months, the majority of patients (81.6%) had a good outcome. On univariate analysis, a duration of illness >3 months, a major motor deficit, bladder involvement, flexor spasms, significant cord compression and spinal extension of the abscess were significantly associated with a poor outcome. However, on multivariate analysis significant cord compression (P=0.003) and spinal extension (P=0.02) showed a significant correlation with a poor outcome.
  
  
  CONCLUSIONS
  Medical management was effective in cervical spine tuberculosis. Patients with significant cord compression and spinal extension of the abscess showed poorer outcome.
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: A
authors.initials: A
authors.lastname: Bhandari
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Garg
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: H S
authors.initials: HS
authors.lastname: Malhotra
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: R
authors.initials: R
authors.lastname: Verma
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: M K
authors.initials: MK
authors.lastname: Singh
authors.affiliation: Department of Microbiology, King George Medical University, Lucknow, India.
authors.forename: A
authors.initials: A
authors.lastname: Jain
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, India.
authors.forename: P K
authors.initials: PK
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000601:surgery; D002648:Child; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents