Ab0167 Spinal Tuberculosis: A Retrospective Study

Background: Spinal tuberculosis (ST) is an extrapulmonary form of tuberculosis caused by Mycobacterium tuberculosis. It is a common form of osteoarticular tuberculosis, particularly in developing countries such as Tunisia. Objectives: Our objective was to clarify the etiological, bacteriological and radiological characteristics but also the progressive characteristics of ST. Methods: We conducted a retrospective study including all patients hospitalized in our Rheumatology department for ST during 22 years. Results: We collected 46 cases of ST divided into 28 women and 18 men (sex ratio: 0.64). The average age was 54.7 years. A history of tuberculosis was noted in eight patients (17.4%). Only seven patients (15.2%) received BCG vaccination. The most frequent reason for consultation was spinal pain, which was observed in all patients. The onset of the disease was progressive in 91.3% of cases (n=42/46). The lumbar spine was the most affected site in 34 cases (73.9%). On physical examination, a neurological deficit was noted in 3 cases and sphincter disorders in one case. The tuberculin skin test was positif in 47.8% of cases. In our series, all patients had a standard radiograph. A decrease in intervertebral disc space was the most common condition (61% of cases). Erosions of the vertebral endplates were observed in half of the cases. An MRI of the spine was done in 45 cases. It confirmed the diagnosis in forty-two cases. In the others three cases, it demonstrate vertebral without disc involvement. The diagnosis of ST was made in 20 patients (43.5%) following a positive histological study or PCR of a neuroimaging guided-needle biopsy from the affected site or a sample of an abscess, in 10 others patients the histological study showed presence of epithelioid cells on the biopsy material. In the remaining 16 cases, the diagnosis was made based on a combination of clinical, paraclinical and evolving arguments under anti-tuberculosis treatment. All patients received anti-tuberculosis treatment. The average duration of anti-tuberculosis antibiotic therapy was 16.1 months (9 months to 29 months). The evolution of the disease was favourable in 32 patients (69.6%). Conclusion: Our series shows that ST mainly affects unvaccinated middle-aged women. Diagnosis is often made late(presence of radiological signs). Biopsy of the disc and vertebra is an important diagnostic contribution. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.