631 - Characteristics of surgically treated tuberculous spondylodiscitis

To study characteristics and outcome of surgically treated tuberculous spondylodiscitis.

Design:

Medical records of patients who were admitted into the physical therapy and rehabilitation ward immediately post surgery of the spine were retrospectively studied. The study included records from January 2010 to october 2024.

Results: Thirthy patients were included. The mean age  was 40.7± 11.9 years. Back pain in 60% of the cases, radicular pain in 15% , fever in 20% and abnormal gait in 60% of the cases. Intradermal reaction for tuberculosis was positive in 9 patients while cultures allowed the diagnosis of tuberculosis in 1 patient. Dorsal localisation was the most frequent(40%) . Surgery was indicated in 80% of cases for spinal cord decompression and in 23% for voluminous abcesses . Complications after surgery were reported in 35.7%. They consisted in spinal instability in 60% of the cases, abcesses in 20% of the cases and the emergence of secondary articular localizations in 20% of the cases. 28.6% of the patients underwent a second surgery mainly to stabalize the spine. Before surgery, walking was impossible for 65% of the patients and 12 months after surgery only 30% of the patients couldn’t walk (p=0.001).

Conclusions:

Spinal surgery in tuberculous  spondylitis may be indicated if medical treatment is insufficient and especially if neurological complications occur. Surgery may be invasive with various complications but sometimes it could be the only option to treat a neurological deficit.