Pattern of presentation and management of spinal tuberculosis at Kenyatta national hospital

Abstract

Over the last ten years 212 patients were treated for spinal tuberculosis and of these 105 had been managed on short course and 102 on long course anti-tuberculous regimen. There was a slight male preponderance with a ratio of 1: 1.17 ( F: M) and majority of the patients were young with 64% of them being under 40 years. In over 90% of the patients there was no associated extra-osseous tuberculosis documented. The ESR was moderately elevated and this decreased gradually in the course of treatment. Mean hospital stay of patients on short term regimen was 1.4 months (SD 0.8 ) and those on long term regimen was 2 months (SD 1.8 ) There was no direct relationship between the incidence of spinal tuberculosis with R.I. V. infection. Only 12.6% were R.I. V positive. 23.3% of the patients treated had not been vaccinated against tuberculosis. The mortality was extremely low even among the R.I. V. positive patients and this was mainly due to cord compression and associated complications in patients who presented late. There was dramatic response to treatment and no significant difference, in the outcome between patients on long course and those on short course treatment.