Tuberculosis Of The Spine In Childhood In Kano, Nigeria

Abstract

Background:
Tuberculosis is a necrotizing bacterial infection with protean manifestation and wide distribution. The involvement of the spine is also increasing because of the resurgence of tuberculosis and HIV.

Objectives:
The objective of this study is to clinically evaluate the outcome of tuberculosis of the spine in children and to assess the prognosis of the deformity associated with TB spine.

Methods:
The study was a retrospective chart review of cases with spinal tuberculosis. Cases were those seen in Department of Paediatrics with the diagnosis of tuberculosis of the spine. The methods of management and prognosis were also assessed in the clinic. During follow-up response to treatment as it affects the neurological deficit was assessed.

Results:
The age distribution was between 8 months and 10 years. The commonest presenting symptoms were swelling at the back in 22 (84.6%). The duration of the swelling before presentation ranged from 4weeks to 2years (mean – 16weeks). Other symptoms included fever, weight loss, anorexia and night sweats. Ninety (73%) of the children were wasted and 22 (84.6%) were febrile. Spinal lesions seen in 22 (84.6%) and there was kyphoscoliosis in 8(30.8%). The most common vertebra involved in the study was the 8th thoracic vertebra. They were all treated conservatively with ant tuberculosis drugs. The deformity in the patients was not cured.
Sixteen (61.5%) had spastic paraplegia at presentation while 6 (23.1%) had spastic paraperesis. Two (7.7%) had flacid paraperesis and the other 2 (7.7%) had flaccid paraplegia.

Conclusion:
Tuberculosis of the spine is still common in children with tuberculosis and treatment does not reverse the deformity associated with it There is therefore a need to explore other ways of managing these cases.


Keywords: childhood. spinal, tuberculosis.

Highland Medical Research Journal Vol. 4 (2) 2006 pp. 39-43