Article

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. CONCLUSION: Medical management was effective in cervical spine
tuberculosis. Patients with significant cord compression and spinal extension of
the abscess showed poorer outcome.

Langue : ANGLAIS