Functional Outcomes of Patients with Nontraumatic Spinal Cord Injury Secondary to Pott’s Disease Admitted at Philippine Orthopedic Center: A Cross-Sectional Study

ABSTRACT

INTRODUCTION

Tuberculosis remains to be a major cause of ill health among developing countries and is one of   the causes of non-traumatic   spinal cord injury. There are far fewer studies pertaining functional   outcomes of non-traumatic spinal cord injury   secondary to Pott’s disease.   Surgery and chemotherapy remain the mainstay of treatment. Functional outcomes utilizing the Spinal Cord   Independence Measure (SCIM) is not well established.

OBJECTIVES

The primary objective of this study is to determine   functional outcomes of patients with spinal cord injury (SCI) secondary to   Pott’s disease.

METHODS

This is a descriptive analytical cross-sectional chart   review of patients with SCI secondary   to Pott’s disease admitted at Philippine Orthopedic Center from   November 2016 to December 2019. Data was obtained from patient charts and recorded to the hospital-based   registry form. Descriptive statistics were utilized to present population   characteristics. SCIM scores were also recorded. Mean SCIM scores were compared at admission and at   discharge. Sub-group analysis was also done among SCIM domains.

RESULTS

Total of 78   patients were included in the study. More than half were males. Ten patients underwent surgery while 68   were treated conservatively. Majority of patients presented with incomplete   and thoracic neurologic level of injury. The mean SCIM scores during admission,   re-evaluation, and discharge are as follows: 30.0±14.7, 49.2±20.5, and 64.3±20.1,   respectively. Statistical analysis showed significant improvement in SCIM score upon discharge compared to admission encompassing three domains: self- care, respiration and sphincter,   and mobility.

CONCLUSION

Pott’s disease is still one of the common etiologies of   non- traumatic spinal cord injury. Surgery is still indicated when presence of neurological   complications arises but must be done as soon as neurological   insult occurs. Anti-TB chemotherapy   is the cornerstone of management. Early detection and initiation of treatment   should be done to maximize   functional outcomes.