Clinical, Biochemical and Radiological Factors Affecting the Prognosis of Neurological Deficit Improvement in Spinal Tuberculosis Patients at Hospitals of Sabah

Authors

  • Zamzuri Zakaria Department of orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
  • Harkeerat Singh Sukhdarshan Singh Department of orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
  • Mohd Ariff Sharifuddin 1 Department of orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia 2 Department of Orthopaedics, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kampung Gong Badak, Terengganu, Malaysia
  • Rajandra Kumar Karupiah Department of orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
  • Mohd Adham Shah Ayeop Department of orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Pahang, Malaysia
  • Naveen Vijayasingham Department of Orthopaedics, Traumatology & Rehabilitation, Hospital Tawau, Tawau, Sabah, Malaysia

DOI:

https://doi.org/10.51200/bjms.v15i3.2731

Keywords:

prognostic factor, spine infection, spinal tuberculosis , thoracolumbar spine

Abstract

The incidence of spinal tuberculosis is highest in developing nations. We aimed to analyse
the clinical, biochemical, and radiological parameters in spinal tuberculosis patients with
significant neurological impairment in relation to their functional outcome. This cross-sectional study involved 224 patients who had been presented to three hospitals in Sabah from July 2017 to June 2018, with significant neurological impairment fulfilling the inclusion criteria were enrolled. Diagnosis of spinal tuberculosis was determined by clinical and radiological factors and confirmed with histopathology, micro bacteriology, and immunoassay. Patients with significant neurology received standard treatment protocol according to the middle pathway regime, anti-tuberculosis for the first three weeks, and were subjected to surgery if there was no improvement. Age, duration of symptoms, c-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white cell count (WCC), thoracolumbar spine involvement, and presence of soft tissue collection were evaluated. Modified Barthel Index (MBI) was used to assess the functional outcome. After a year, 146 patients (65.1%) had good functional outcomes and 78 patients had no significant improvement. On univariate analysis, there were no significant correlations between functional outcome and age (p>0.45); duration of symptoms (p>0.68); CRP (p>0.76); WCC (p>0.99); and presence of soft tissue collection (p>0.21).. High ESR (p<0.008) and thoracolumbar lesions were associated with poor functional outcomes (p<0.033). Higher ESR values and thoracolumbar lesions were associated with poor prognostic factors functional outcome in spinal tuberculosis patients.

Published

2021-09-30

How to Cite

Zamzuri Zakaria, Harkeerat Singh Sukhdarshan Singh, Mohd Ariff Sharifuddin, Rajandra Kumar Karupiah, Mohd Adham Shah Ayeop, & Naveen Vijayasingham. (2021). Clinical, Biochemical and Radiological Factors Affecting the Prognosis of Neurological Deficit Improvement in Spinal Tuberculosis Patients at Hospitals of Sabah. Borneo Journal of Medical Sciences (BJMS), 15(3), 37–47. https://doi.org/10.51200/bjms.v15i3.2731
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