ABSTRACT
Background and aim of the study: Multilevel noncontiguous spinal tuberculosis is an atypical form of the spinal tuberculosis, which leaves not less than two adjacent vertebrae intact between the two foci. The aim of this study is to record the incidence, pattern of presentation, risk factors; and diagnostic tools of multi-level noncontiguous vertebral tuberculosis in a single center [King Abdul Aziz Specialist Hospital] Taif, Saudi Arabia
Patients and method: In this retrospective chart review study, we reviewed the records and data of all patients presented to King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia from January 2009 to January 2014 and their diagnosis were proved to be spinal tuberculosis
Results: the study included76 patients with spinal tuberculosis; multilevel noncontiguous tuberculosis was detected in 18.4% and a single spinal lesion was identified in the other 81.6%of patients. There was no statistically significant difference between the 2 groups regarding their demographic, clinical, and their laboratory findings except for the hepatitis B virus [HBV] positivity and elevated serum transaminases which were significantly higher in the multilevel non contagious group of patients. Plain film detected multiple non contagious lesions in 64.3% of patients, and in 35.7%of them, they were first diagnosed as single lesion but MRI detected the multiplicity. The thoracic and lumbar vertebrae were involved in 85.7% of the multilevel lesions and in the other 14.3% of patients the cervical and lumbar involvement was detected. In the single focus group the thoracic and thoracolumbar vertebrae were involved in 75.8% of cases. Diagnosis was confirmed by culture and histopathology
Conclusion: This study suggested a strong relation between hepatitis B and spinal tuberculosis, specially the multilevel non contagious form, however, till similar results of larger series of patients are obtained, the orthopedic surgeon must be with high index of suspicion in patients with spinal tuberculosis to detect multiplicity by MRI and any co infection with hepatitis B virus