Surgical outcomes among spinal tuberculosis patients: a study from a provincial reference hospital in Indonesia

Abstract

Link of Video Abstract: https://youtu.be/_5_xwPSsNFc   Introduction: Spinal tuberculosis is one of the most common forms of extrapulmonary tuberculosis, which can cause a significant loss of functional ability and decrease in quality of life. Surgery has become an integral component in the current management of spinal tuberculosis that could improve neurological deficits and functional status, yet it may expose patients to surgical site infection (SSI). The aim of the study was to observe the incidence of SSI and improved neurological deficits and functional status post-surgery among patients with spinal tuberculosis. Methods: The medical records (n=91) were collected retrospectively from patients admitted between January 2019 and June 2022. Characteristic data collected in this study included age, gender, education, occupation, domicile, history of smoking, history of pulmonary tuberculosis, presence of comorbidity. Patients were contacted for history of SSI, postoperative neurological deficits, and functional status assessments through interview using Frankel Grade and Barthel Index instruments, respectively. Results: The results revealed that only two percent of the total patients developed SSI. Number of patients with Frankel Grade E increased from 0 to 72 (79.1%), and only three patients (3.3%) had persistent Frankel Grade B after the surgery. Sixty-eight patients (74.7%) who underwent the surgery enjoyed independent state of functional status, whereas prior to the surgery, the number was smaller (n=18, 19.8%). The favorable surgical outcomes were found predominantly in female patients (83.9%), 17–25-year-old patients (93.3%), and those having no history of smoking (82.5%–84.2%) and comorbid disease (81.9%–83.3%). The recovery was mostly observed 1–2 years post-surgery (87.2%). Conclusion: Spinal surgery for patients with spinal tuberculosis improves neurological deficits and functional status. The risk of contracting SSI after the surgery is considered to be low.