Mycobacterium tuberculosis remains one of the major causes of chronic spondylodiscitis, particularly in endemic regions. Delayed diagnosis may result in severe structural destruction and irreversible spinal deformities. Therefore, characterization of the epidemiological and clinical features of affected patients is essential to improve diagnostic accuracy and reduce mortality and long-term neurological disability.
Methods: This descriptive cross-sectional study was conducted on 89 patients with confirmed tuberculous spondylodiscitis referred to Imam Khomeini Hospital between 2010-2020. Diagnosis was established based on histopathological, microbiological, and radiological findings together with clinical response to anti-tuberculosis therapy.
Results: The mean age of patients was 51.34 ± 16.18 years. Among them, 85.4% were Iranian nationals and 14.6% were Afghan. The mean white blood cell (WBC) count at admission was 7.4 × 10³/μL. The most common presenting complaint was spinal pain (86.2%), followed by fever (76.1%), weight loss (40.4%), and anorexia (36.0%). Concomitant pulmonary and pleural involvement was observed in 23.6% and 11.2% of patients, respectively. Regarding anatomical distribution, thoracic involvement was present in 51.7%, lumbar involvement in 42.7%, and thoracolumbar junction involvement in 9.0% of cases. Epidural abscesses were detected in 58.4%, paravertebral abscesses in 55.0%, and psoas abscesses in 25.8% of patients. All patients received standard four-drug anti-tuberculosis therapy, while surgical intervention, mainly laminectomy, was performed in 32.6% of cases.
Discussion: Tuberculous spondylodiscitis remains an important cause of severe spinal deformities and neurological complications. Early diagnosis and comprehensive paraclinical evaluation are strongly recommended to ensure timely initiation of anti-mycobacterial therapy and prevent permanent disability.