Tuberculosis Of The Spine In Nigeria: Has Anything Changed?

Objective: To review the patterns of presentation, available treatment methods and outcome of tuberculosis of the spine at our centre. Methods: A retrospective review of all patients with tuberculosis of the spine seen at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from 1st January 1999 to 31st December, 2005 was carried out. The clinical features, laboratory test results, radiologic features, treatment methods and outcome were analyzed. Results: A total of 62 patients with Tuberculosis of the spine were seen and treated during the study period out of which 49 had complete information suitable for analysis. These consisted of 24 males (49%) and 25 females (51%) with a mean age of 32.8 + SD. Students (30.6%) and traders (26.5%) were the most affected groups. Back pain (85.7%) and weakness of the lower limbs (87.7%) were the commonest presenting complaints. The most commonly involved region of the spine was the lumbar spine (49%) with 37patients (75.5%) having multiple consecutive vertebral involvement. The commonest radiographic pattern was wedge collapse of the vertebral bodies and destruction of the intervertebral disc (63.3%). Human Immunodeficiency Virus (HIV) screening was confirmed positive in 2 (7.4%) out of 27 patients that had the test. Only 24 patients (49%) had satisfactory healing with no persisting spine deformity or paraplegia. Conclusion: The incidence of tuberculosis of the spine continues to rise. The outcome of the modalities of management presently available is unsatisfactory. There is need to improve the facilities for spinal surgery so that our patients can maximally benefit from a combination of surgery and chemotherapy.