Affiliations: [a]
Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| [b] Department of Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| [c] University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands
| [d]
Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Spine Center Groningen, Groningen, The Netherlands
| [e]
Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Correspondence:
[*]
Address for correspondence: Onno W. Akkerman, MD, PhD., Department of Pulmonary Diseases and Tuberculosis, University Medical Center, Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Tel.: +31503610857; Fax: +31 50 3618152; E-mail: [email protected].
Abstract: BACKGROUND: Spinal tuberculosis (TB) accounts for approximately 1% to 3% of all TB cases and it can cause a wide range of neurological symptoms, from none to a complete spinal cord injury (SCI), resulting in complete paraplegia or tetraplegia. OBJECTIVES: To describe the functional and neurological outcome of SCI caused by TB. METHODS: Retrospective data on the admission period was combined with prospectively collected data on long-term follow-up. Primary outcome was neurological outcome in terms of motor function. Secondary outcome measures were functional outcome in terms of level of independence and community participation. Results were compared to the outcome in patients with SCI due to trauma. RESULTS: Six TB patients with complete motor SCI (American Spinal Injury Association Impairment Scale (AIS) A or B) were compared to eighteen patients with traumatic SCI. Most TB patients regained almost full neurological function (median motor score improved from 50 to 100), and reached high levels of independence, whereas trauma patients did not improve neurologically (median motor score remained 50) and reached a plateau in level of independence. CONCLUSIONS: SCI due to tuberculosis in the Netherlands shows remarkable improvement in both neurological and functional outcome, especially compared with traumatic SCI.
