Correlation of conventional histopathology and GeneXpert MTB/RIF in the diagnosis of spinal tuberculosis.

Introduction: Spinal tuberculosis (STB) remains a significant health burden in tuberculosis-endemic regions, including India. Diagnosis is challenging because conventional microbiological methods, including acid-fast staining and mycobacterial culture, have limited sensitivity in paucibacillary disease. This study evaluated the diagnostic performance of GeneXpert MTB/RIF in comparison with conventional histopathological examination (HPE) for the diagnosis of STB. Materials and Methods: This retrospective study included 64 patients with clinical and radiological suspicion of spinal tuberculosis who underwent transpedicular biopsy. Patients with definitive GeneXpert MTB/RIF and histopathological examination results were included. Statistical analysis was performed using SPSS version 24.0 (IBM Corp., Armonk, NY, USA). Results: Histopathology was positive in 46 (71.9%) patients, while GeneXpert MTB/RIF was positive in 63 (98.4%); both tests were positive in 45 (70.3%) cases. Compared with histopathology, GeneXpert demonstrated 97.83% sensitivity, 0% specificity, 71.43% positive predictive value, and 70.31% overall accuracy. The association between GeneXpert and HPE results was not statistically significant (χ² = 0.398, p = 0.528). Conclusion: GeneXpert MTB/RIF is a rapid and sensitive adjunct to histopathology in the diagnosis of STB. However, the absence of specificity and the modest overall diagnostic accuracy observed in this study should warrant a cautious interpretation of this diagnostic tool.