Clinical and radiological outcomes of spinal tuberculosis: A retrospective study

To characterise clinical and radiological features of spinal tuberculosis (TB) at presentation, mid-treatment and treatment completion.

We conducted a retrospective study of patients diagnosed with spinal TB between 2011-2022 across three London hospitals. Demographic and clinical data were collected at presentation, mid-treatment and on treatment completion. MRI findings at each time point were classified using a standardised scoring system. Clinical symptoms were scored according to severity.

Sixty-two cases were evaluated. Most were male (45/62, 73%) and migrants (52/62, 84%); median age was 33 years (IQR, 26-40). Back or neck pain was the predominant presenting symptom (55/62, 89%). The thoracic spine was most frequently involved (41/62, 66%), and over one-third had multi-level disease. Five patients (8%) had spinal cord compression; three required surgery. Median TB treatment length was 12 months (IQR, 12-12). Radiological and clinical scores both improved significantly during treatment, with greater improvement at 12 months than at 6 months. Radiological improvement correlated with clinical improvement at both time points. No TB-related deaths occurred; however, 12/62 (19%) experienced long-term complications.

Patients with spinal TB may benefit from an individualised treatment duration guided by clinical and radiological response; further studies are required to clarify the optimal approach.