Surgical Outcomes of Complicated Spinal Tuberculosis: A Prospective Observational Study of 56 Operated Cases at NITOR

Open Access

Abstract

Background: Spinal tuberculosis remains a major cause of neurological disability in endemic regions, with complicated cases frequently requiring surgical intervention. Prospective outcome data from high-burden, resource-limited settings remain limited. Objective: To evaluate surgical outcomes in patients with complicated spinal tuberculosis treated at a national tertiary orthopedic referral center. Methods & Materials: This prospective observational study included 56 surgically treated patients with complicated spinal tuberculosis managed between January 2020 and June 2025. Neurological status was assessed using the Kumar et al. grading system. Outcomes evaluated included pain severity using the visual analog scale, neurological recovery, deformity correction, bony fusion, and perioperative and postoperative complications. Results: The mean age was 38.4 ± 12.8 years, with a near-equal sex distribution. Thoracolumbar and thoracic involvement predominated. Preoperatively, 71.4% of patients had Grade 3 or 4 neurological deficits. Postoperatively, pain scores improved from 8.2 ± 1.02 to 3.5 ± 0.9, and higher neurological grades markedly decreased. Deformity correction and bony fusion were achieved in 89.2% of patients, with no implant failure. Complications were acceptable, and 14.2% of patients showed no neurological improvement. Conclusion: Surgical management of complicated spinal tuberculosis provides significant pain relief, neurological improvement, and durable spinal stabilization, supporting its role as an effective treatment option in endemic, resource-constrained settings.