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Bone tuberculosis: results and experience in Leicestershire
British Journal of Diseases of the Chest
|July 1, 1986
Summary
Bone tuberculosis, particularly spinal tuberculosis, is common in Indian subcontinent immigrants. Treatment with chemotherapy is effective and well-tolerated, with no new neurological complications observed during the study period.
Area of Science:
- Orthopedics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis management extends to extrapulmonary sites, including bone tuberculosis.
- Bone tuberculosis diagnosis relies on bone involvement evidence combined with microbiological or histological confirmation.
- The Indian subcontinent (ISC) population has a higher prevalence of tuberculosis.
Purpose of the Study:
- To survey the notification and characteristics of bone tuberculosis cases in Leicestershire between 1978 and 1983.
- To analyze diagnostic methods, treatment outcomes, and complications of bone tuberculosis, especially spinal tuberculosis.
- To evaluate the impact of bed rest and chemotherapy on spinal tuberculosis patients with and without cord compression.
Main Methods:
- Retrospective survey of 81 notified bone tuberculosis cases in Leicestershire (1978-1983).
- Confirmation of tuberculosis in 69 patients through bone involvement, positive cultures for Mycobacterium tuberculosis, or suggestive histology.
- Analysis of patient demographics, symptom duration, affected sites, diagnostic methods, and treatment regimens (chemotherapy, bed rest).
Main Results:
- 75 of 81 notified cases were traced, with 69 confirmed bone tuberculosis cases (mean age 40.2 years, 39 male, 54 from ISC).
- Spine was the most common site (37 patients), frequently associated with abscess formation (17 patients).
- Chemotherapy (mean 16.2 months) was well-tolerated; no resistant organisms were found. Four patients with spinal cord compression received bed rest and decompression, with one mortality. No new neurological signs developed during treatment.
Conclusions:
- Spinal tuberculosis is prevalent in the ISC immigrant population in Leicestershire.
- Chemotherapy is effective and safe for bone tuberculosis, including spinal tuberculosis, without leading to new neurological deficits.
- For spinal tuberculosis patients without cord compression, outcomes were similar regardless of bed rest duration.