PT  - JOURNAL ARTICLE
AU  - Deepak Sakaram Rao
AU  - Richard Hopkins
AU  - Billy L.K. Wong
AU  - Elena Karampini
AU  - Bassey Asuquo
AU  - Thomas C. Stokes
TI  - Spinal tuberculosis in South London Hospital – A 5 year review of our experience
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2722
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2722.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2722.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: The incidence of tuberculosis (TB) in southeast London has risen by 25% over the last 10 years and is 4 times greater than the national average. Extra pulmonary involvement is seen in 47% and spinal TB accounts for 2-3%. Diagnosis of spinal TB can be delayed due to nonspecific nature of symptoms. This study evaluates our experience of managing spinal TB at Queen Elizabeth Hospital in Woolwich, UK.Aim: Determine the local incidence of spinal TB at Woolwich.Analyse delays in referral and diagnosis of spinal TB.Methods: A retrospective case note review of recorded data was performed of all the spinal TB patients referred to QEH over 5 years (Jan 2006- 2011). 27 of total 33 patients had case notes available for review. Mean age at diagnosis was 47 years (range 29-78 years). 88% of patients presented with back pain, with or without neurological compromise.The overall incidence of spinal TB was 5.6% (national average 2-3%).The mean delay was 81 days (3-439) from onset of symptoms to first presentation and 99 days (3-552) from onset of symptoms to referral. There was an average delay of 33 days (12-303) from initiation of referral to diagnosis.47% had confirmed histological diagnosis with culture.15% had paravertebral abscesses with no bony involvement seen on imaging.Combination chemotherapy was the main modality of treatment. 24 (88%) patients were managed with combination chemotherapy alone.Further details into the delays and consequences were looked into.Conclusion: This study highlights fact that awareness of demographic and local incidence, together with high index of clinical suspicion in areas with relatively high incidence would facilitate early diagnosis and treatment of spinal TB.