Spinal Tuberculosis: An Exhaustive Diagnosis.

Area of Science:

• Neurosurgery
• Microbiology
• Orthopedics

Background:

• Spinal tuberculosis (TB) affects nearly half of patients with musculoskeletal TB.
• Diagnosing spinal TB presents significant challenges, necessitating a range of investigations.
• Extrapulmonary TB, including spinal involvement, is less common than pulmonary TB.

Purpose of the Study:

• To evaluate diagnostic methods for spinal tuberculosis.
• To identify the most effective and timely diagnostic approach for spinal TB.

Main Methods:

• A retrospective study analyzed 100 spinal TB patients from January 2021 to November 2023.
• Data collected included patient demographics, diagnostic investigations, time to diagnosis, histopathology, and surgical intervention.
• Evaluations were conducted in the Neurosurgery and Microbiology Departments.

Main Results:

• Imaging and computed tomography (CT)-guided biopsy were the most effective diagnostic tools for spinal TB.
• Histopathology provided the earliest diagnostic results.
• Pus culture, smear microscopy, and nucleic acid amplification tests (NAAT) showed low positivity yields despite high sensitivity.

Conclusions:

• Imaging and CT-guided biopsy are the optimal and earliest methods for diagnosing spinal TB, with biopsy confirming the diagnosis.
• Acid-fast bacilli (AFB) and NAAT are supplementary diagnostic tests.
• Relying solely on AFB, NAAT, and GeneXpert tests for diagnosis can lead to sample wastage and diagnostic delays.