Abstract
Background. Tuberculosis (TB) is a major public health concern, especially in developing countries such as Namibia, where spinal TB accounts for 50% of all skeletal TB cases.
Objective. To determine the clinical manifestations and most common identifiable radiological features of spinal TB, and to identify the most frequently affected vertebral level. This will aid in future diagnoses and prompt treatment regarding spinal TB cases in Namibia.
Method. A retrospective cross-sectional study design was adopted to review patient records of individuals diagnosed with spinal TB in 2019 at Windhoek Central Hospital (Namibia). Non-probability sampling was used, and patient demographics, clinical presentation and radiological features were recorded and analysed.
Results. Thirty patients (17 female and 13 male) were included in this study. Weight loss was the main clinical complaint (53%), while local tenderness (30%) was the most common physical examination finding. Eighteen of the 30 patients (60%) had varying degrees of neurological deficits. The most common imaging technique used was computed tomography (CT) (n=29, 97%), followed by magnetic resonance imaging (MRI) (3%). Intervertebral disk space/disk involvement was the most common radiological feature identified on imaging (57%), followed by abscess formation (50%). Vertebral lesions involved the lumbar (50%) and the thoracolumbar spine (23%). L1 and L2 were most commonly affected (48% and 44%, respectively), followed by T12 and L3 (32% each).
Conclusion. Early stage diagnosis of spinal TB is highly challenging. Patients are often misdiagnosed and/or mismanaged. Thus, it is essential to enhance screening techniques and educate healthcare professionals on common signs, symptoms and radiological features of spinal TB. This will allow prompt detection and help to prevent debilitating complications associated with the disease to manifest.
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