Predicting neurological deficit in patients with spinal tuberculosis - A single-center retrospective case-control study.
Neurologic deficit
Pott’s paraplegia
Risk factors
Spinal tuberculosis
Journal
SICOT-J
ISSN: 2426-8887
Titre abrégé: SICOT J
Pays: France
ID NLM: 101675099
Informations de publication
Date de publication:
2021
2021
Historique:
received:
16
12
2020
accepted:
26
01
2021
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
6
3
2021
Statut:
ppublish
Résumé
Identifying the risk factors for the neurological deficit in spine tuberculosis would help surgeons in deciding on early surgery, thus reducing the morbidity related to neurological deficit. The main objective of our study was to predict the risk of neurological deficit in patients with spinal tuberculosis (TB). The demographic, clinical, radiological (X-ray and MRI) data of 105 patients with active spine TB were retrospectively analyzed. Patients were divided into two groups - with a neurological deficit (n = 52) as Group A and those without deficit (n = 53) as Group B. Univariate and multivariate logistic regression analysis was used to predict the risk factors for the neurological deficit. The mean age of the patients was 38.1 years. The most common location of disease was dorsal region (35.2%). Paradiscal (77%) was the most common type of involvement. A statistically significant difference (p < 0.05) was noted in the location of disease, presence of cord compression, kyphosis, cord oedema, loss of CSF anterior to the cord, and degree of canal compromise or canal encroachment between two groups. Multivariate analysis revealed kyphosis > 30° (OR - 3.92, CI - 1.21-12.7, p - 0.023), canal encroachment > 50% (OR - 7.34, CI - 2.32-23.17, p - 0.001), and cord oedema (OR - 11.93, CI - 1.24-114.05, p - 0.03) as independent risk factors for predicting the risk of neurological deficit. Kyphosis > 30°, cord oedema, and canal encroachment (>50%) significantly predicted neurological deficit in patients with spine TB. Early surgery should be considered with all these risk factors to prevent a neurological deficit.
Sections du résumé
BACKGROUND
BACKGROUND
Identifying the risk factors for the neurological deficit in spine tuberculosis would help surgeons in deciding on early surgery, thus reducing the morbidity related to neurological deficit. The main objective of our study was to predict the risk of neurological deficit in patients with spinal tuberculosis (TB).
METHODS
METHODS
The demographic, clinical, radiological (X-ray and MRI) data of 105 patients with active spine TB were retrospectively analyzed. Patients were divided into two groups - with a neurological deficit (n = 52) as Group A and those without deficit (n = 53) as Group B. Univariate and multivariate logistic regression analysis was used to predict the risk factors for the neurological deficit.
RESULTS
RESULTS
The mean age of the patients was 38.1 years. The most common location of disease was dorsal region (35.2%). Paradiscal (77%) was the most common type of involvement. A statistically significant difference (p < 0.05) was noted in the location of disease, presence of cord compression, kyphosis, cord oedema, loss of CSF anterior to the cord, and degree of canal compromise or canal encroachment between two groups. Multivariate analysis revealed kyphosis > 30° (OR - 3.92, CI - 1.21-12.7, p - 0.023), canal encroachment > 50% (OR - 7.34, CI - 2.32-23.17, p - 0.001), and cord oedema (OR - 11.93, CI - 1.24-114.05, p - 0.03) as independent risk factors for predicting the risk of neurological deficit.
CONCLUSION
CONCLUSIONS
Kyphosis > 30°, cord oedema, and canal encroachment (>50%) significantly predicted neurological deficit in patients with spine TB. Early surgery should be considered with all these risk factors to prevent a neurological deficit.
Identifiants
pubmed: 33666548
doi: 10.1051/sicotj/2021002
pii: sicotj200148
pmc: PMC7934611
doi:
Types de publication
Journal Article
Langues
eng
Pagination
7Informations de copyright
© The Authors, published by EDP Sciences, 2021.
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