title: Demographics of tuberculosis of spine and factors affecting neurological improvement in patients suffering from tuberculosis of spine: a retrospective analysis of 312 cases.
abstract: OBJECTIVE
  The purpose of the study was to study demographics of tuberculosis of spine and analyze factors that might affect neurological improvement in such patients.
  
  
  METHODS
  Of the 638 suspected cases of spinal tuberculosis, 312 cases with confirmed diagnosis with at least 1-year follow-up were selected for retrospective analysis. Two hundred cases who presented with neurological deficit were further divided into three groups-completely improved, partially improved and no improvement according to American Spinal Injury Association impairment scale (AIS) grading. All continuous variables and categorical variables were compared across groups.
  
  
  RESULTS
  A total of 209 (66.99%) patients had typical clinical presentation. A total of 264 (84.62%) had typical magnetic resonance imaging (MRI) presentation. Among 356 involved vertebrae, thoracic levels (T1-10) were most commonly affected in 163 (45.78%) followed by thoracolumbar (T11-L2) vertebrae in 98 (27.52%). In 250 patients (80.12%), disease was restricted to one or two adjoining vertebrae. At presentation, 112 (35.89%) patients were neurologically intact, whereas 97 (31%) were AIS D, 65 (20.83%) were AIS C, 8 (2.5%) were AIS B and 30 (9.61%) were AIS A. On statistical analysis, although three groups of patients with complete improvement, partial improvement and no improvement were similar in age, sex, radiological presentation, and co-morbidities and the presence of pulmonary tuberculosis, they were significantly different with regard to the levels of vertebral involvement, AIS grade at presentation, bladder and bowel involvement and its duration.
  
  
  CONCLUSIONS
  In management of patients suffering from tuberculosis of spine, levels of vertebral involvement, AIS grade at presentation, bladder and bowel involvement and its duration significantly affect the final neurological improvement.
authors.affiliation: Department of Spine Services, Indian Spinal Injuries Center, New Delhi, India.|Department of Orthopedic and Spine Surgery, Dr B R Ambedkar Central Railway Hospital, Mumbai, India.
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Spine Services, Indian Spinal Injuries Center, New Delhi, India.
authors.forename: H S
authors.initials: HS
authors.lastname: Chhabra
authors.affiliation: Department of Spine Services, Indian Spinal Injuries Center, New Delhi, India.
authors.forename: T
authors.initials: T
authors.lastname: Chabra
authors.affiliation: Department of Spine Services, Indian Spinal Injuries Center, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Mahajan
authors.affiliation: Department of Spine Services, Indian Spinal Injuries Center, New Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Batra
authors.affiliation: Department of Spine Services, Indian Spinal Injuries Center, New Delhi, India.
authors.forename: G
authors.initials: G
authors.lastname: Sangondimath
mesh_terms: D000367:Age Factors; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D061665:Time-to-Treatment; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy*