Spinal infections in adult Indian population: clinical study and management of various spectrums- An Institutional Experience

Abstract

Background: Spinal infection (SI) by definition is an infectious disease affecting the vertebral body, the intervertebral disc, and/or adjacent paraspinal tissue.In this observational study, we describe patient distribution, etio-pathogenesis, clinical presentation of spinal infections in adults and their best possible management, that is  conservative/ surgical along with follow up in a tertiary care hospital attached to a medical college in India.

Materials and Methods: This study was carried out from July 2017  to March 2020 in the Neurosurgery department of a tertiary care hospital attached to a medical college in India. We enrolled 90 patients for our study. Outcome and complications assessments were carried out for all patients over a period of two years.

Results Out of 90 cases 57(63.3%) were male & 33(36.6%)were female, 58(64.4%) were in the age group of 30-40yrs, 74(82.2%) were from lower socio economic status(as per modified Kuppuswamy scale). Location wise, 21 (23.3%) were in the cervical region, 18 (20%) in dorsal, 34 (37.7%) in dorsolumbar and 17(18.8%) in the lumbo sacral region. 56 (62.2%) patients underwent surgery, out of which 24 (26.6%) patients were diagnosed as tuberculosis on biopsy, 11 patients grew staphylococcus aureus,03 were positive for fungi,  rest showed no growth/no organisms on microscopy. 34 patients were managed conservatively with CT guided biopsy and antibiotics /ATT. of the 90 patients, 16(17.77%) were lost to follow up, of the remaining 74, 17(18.88%) came in category (a) 23(25.5%) in category (b) and 34(37.77%) came in category (c).

Conclusion: We conclude by saying that Tuberculosis remains the most common cause of spinal infection in India even now. Detailed workup helps to decide treatment strategy either Conservative and surgical.