Demographic Profile, Clinical Characteristics, and Short-Term Outcomes of Tuberculosis Spondylitis in a Tertiary Medical Center in Southern Philippines A 10-year Retrospective Review
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Abstract
Background. Tuberculous spondylitis remains a significant cause of morbidity in the Philippines, with limited local outcome data.
Objective. To describe the demographic profile, clinical characteristics, management, and outcomes of patients with tuberculous spondylitis treated at a tertiary-level medical center from 2015 to 2024.
Methodology. This was a 10-year retrospective chart review of patients diagnosed with tuberculous spondylitis. Demographic, clinical, radiographic, and management data were collected and analyzed.
Results. A total of 69 patients were included. Most patients were male (63.6%) and unemployed (63.6%). The mean age was 40 years (range, 19–59). Thoracic involvement was reported in 59% of cases. Back pain was reported at 48.5%, and neurologic deficits were reported at 27.3%. On neurologic assessment at presentation, 50% had incomplete neurologic deficits and 10.6% had complete deficits. Management consisted of anti-tuberculous therapy alone in 59.1% and anti-tuberculous therapy with bracing in 21.2%. Thirteen patients (19.7%) underwent surgery, performed via a posterior approach. In the surgical cohort, the mean preoperative kyphosis angle was 47.7 degrees (range, 39–79 degrees), and the mean postoperative kyphosis angle was 40.8 degrees (range, 27–55 degrees). Neurologic recovery was documented among patients with incomplete deficits. The mean interval from surgery to discharge was 51 days. At two years, more than 90% of patients were lost to follow-up.
Conclusion. Tuberculous spondylitis in this cohort was observed predominantly among unemployed young to middle-aged males, involving the thoracic spine, with a substantial proportion presenting with neurologic compromise. Among surgically treated patients, posterior surgery was associated with modest deformity correction and neurologic improvement during the early postoperative period. Long-term outcomes could not be reliably assessed due to >90% loss to follow-up at two years. Strengthened early detection, improved continuity of care, and inclusion of functional outcomes in future studies are recommended.
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