According to the recent World Health Organization reports, about one-third of the world population is infected with Mycobacterium tuberculosis (MTB) bacilli. Mycobacterial spondylitis/spondylodiscitis accounts for approximately 1-2% of all TB cases. The spine is the most frequent location (50%) of osteoarticular TB. Herein, we describe a retrospective series of mycobacterial spondylitis/spondylodiscitis cases in two neurological referral centers. A total of 136 patients, attending the Instituto Nacional de Neurología y Neurocirugía, Mexico, and the National Institute of Mental Health and Neurosciences, Bangalore, India, from January 2008 to December 2013, were retrospectively included. Inclusion criteria were epidemiological data suggestive of TB, like history of pulmonary or miliary disease, or chest X-ray abnormalities. Diagnosis was based on clinical and neuroimaging findings, and it was confirmed by a histopathological examination of biopsy specimens, by Lowenstein-Jensen culture, or by a combination of positive MTB polymerase chain reaction (PCR) and a positive radiological response to empirical antituberculous treatment. All qualitative variables were expressed as a percentage of occurrence and compared using the chi-square distribution. Differences were considered as statistically significant at P < 0.05. Quantitative variables were expressed as median ± standard deviation. Either a two-tailed Student’s t-test or a Mann-Whitney test was used to compare our series with the cases reported in the literature, based on the Kolmogorov-Smirnov test. Combined motor and sensitive deficits were observed in 104 patients (76.4%); sphincter alteration was observed in 27 (19.8%). Only 6.6% of patients had a history of pulmonary or miliary TB. The thoracic region was the most frequent lesion site, found in 69% of patients, followed by lumbar and cervical locations. Multilevel involvement was observed in 8% of cases. Only 59.5% of patients showed some clinical improvement. The non-specific symptoms of early mycobacterial spondylitis/spondylodiscitis may contribute to a delayed clinical diagnosis.
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