1
|
Qi F, Luo L, Qu C, Bao W, Wang W, Zhu X, Wu D. Combined clinical significance of MRI and serum mannose-binding lectin in the prediction of spinal tuberculosis. BMC Infect Dis 2024; 24:618. [PMID: 38907240 PMCID: PMC11193271 DOI: 10.1186/s12879-024-09462-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/03/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Spinal tuberculosis (STB) is a local manifestation of systemic infection caused by Mycobacterium tuberculosis, accounting for a significant proportion of joint tuberculosis cases. This study aimed to explore the diagnostic value of MRI combined with mannose-binding lectin (MBL) for STB. METHODS 124 patients suspected of having STB were collected and divided into STB and non-STB groups according to their pathological diagnosis. Serum MBL levels were measured using ELISA and a Pearson analysis was constructed to determine the correlation between MBL and STB. ROC was plotted to analyze their diagnostic value for STB. All the subjects included in the study underwent an MRI. RESULTS The sensitivity of MRI for the diagnosis of STB was 84.38% and specificity was 86.67%. The serum MBL levels of the patients in the STB group were significantly lower than the levels in the non-STB group. ROC analysis results indicated that serum MBL's area under the curve (AUC) for diagnosis of STB was 0.836, with a sensitivity of 82.3% and a specificity was 77.4%. The sensitivity of MRI combined with MBL diagnosis was 96.61%, and the specificity was 92.31%, indicating that combining the two diagnostic methods was more effective than using either one alone. CONCLUSIONS Both MRI and MBL had certain diagnostic values for STB, but their combined use resulted in a diagnostic accuracy than either one alone.
Collapse
Affiliation(s)
- Fei Qi
- Department of Orthopedics, Wuhan Hankou Hospital, Wuhan, 430000, Hubei Province, China
| | - Lei Luo
- Department of Orthopedics, Guangzhou Huaxin Orthopaedic Hospital, Shantou University, Guangzhou, 510630, Guangdong Province, China
| | - Chuangye Qu
- Department of Orthopedics, Lanzhou Petrochemical General Hospital (The Fourth Affiliated Hospital of Gansu University of Traditional Chinese Medicine), Lanzhou, 730060, Gansu Province, China
| | - Weibing Bao
- Department of Radiology, Gansu Provincial Hospital of Traditional Chinese Medicine (The First Affiliated Hospital of Gansu University of Traditional Chinese Medicine), No. 418 Guazhou Road, Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Wenqi Wang
- Department of Radiology, Gansu Provincial Hospital of Traditional Chinese Medicine (The First Affiliated Hospital of Gansu University of Traditional Chinese Medicine), No. 418 Guazhou Road, Qilihe District, Lanzhou, 730050, Gansu Province, China
| | - Xiaozhong Zhu
- Department of Radiology, Gansu Provincial Hospital of Traditional Chinese Medicine (The First Affiliated Hospital of Gansu University of Traditional Chinese Medicine), No. 418 Guazhou Road, Qilihe District, Lanzhou, 730050, Gansu Province, China.
| | - Dengjiang Wu
- Department of Orthopedics, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621, Gangwan Road, Huangpu District, Guangzhou City, 510700, Guangdong Province, China.
| |
Collapse
|
2
|
Dhouibi J, Kalai A, Chaabeni A, Aissa A, Ben Salah Frih Z, Jellad A. Rehabilitation management of patients with spinal tuberculosis (Review). MEDICINE INTERNATIONAL 2024; 4:28. [PMID: 38660125 PMCID: PMC11040281 DOI: 10.3892/mi.2024.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024]
Abstract
Spinal tuberculosis (ST) is a serious condition and a global health concern, accounting for a significant portion of musculoskeletal tuberculosis cases. It can lead to sever spinal and neurological complications. The management of ST involves a multidisciplinary approach, including medical treatment, surgery and rehabilitation. Rehabilitation is crucial through the course of the disease's and is tailored for each stage according to the patients' complaints, and clinical and functional complications. In the case of neurological issues due to spinal compression, rehabilitation aims at overcoming bed confinement complications, involving mobilization techniques, strengthening exercises and related vesico-sphincter disorders (urodynamics, catheterizing). The role of rehabilitation for the management of pain in patients with ST is based on bracing (restricting movements and relieving the pressure on harmed structures), and analgesic physical means (electrical stimulation and massage techniques). Several rehabilitation options may be used to address musculoskeletal complications. Range of motion exercises, muscle strengthening, and posture and balance correction using sensory perception and proprioception techniques, are commonly involved. Cardiorespiratory reconditioning is required to improve respiratory function, walking ability and cardiovascular endurance. Ultimately, rehabilitation allows for the minimization of disability and the prevention of the loss of autonomy, particularly in elderly patients. The advantage of the rehabilitation approach is its multi-optional characteristics including physical therapy, occupational therapy, ergonomic advices and assistive equipment. Despite its crucial role, rehabilitation remains understudied in the management of ST. Thus, the present mini-review aimed to address the rehabilitation options for the clinical features and complications of ST, according to the course of the disease.
Collapse
Affiliation(s)
- Jaouher Dhouibi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Amine Kalai
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Amr Chaabeni
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Ahlem Aissa
- Regional Hospital of Enfidha, Sousse 4030, Tunisia
| | - Zohra Ben Salah Frih
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| | - Anis Jellad
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Monastir, Monastir 5000, Tunisia
| |
Collapse
|
3
|
Kilinc F, Setzer M, Behmanesh B, Jussen D, Geßler F, Prinz V, Czabanka M. Surgical management and clinical outcome of cervical, thoracic and thoracolumbar spinal tuberculosis in a middle-European adult population. Sci Rep 2023; 13:7000. [PMID: 37117321 PMCID: PMC10147912 DOI: 10.1038/s41598-023-34178-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 04/25/2023] [Indexed: 04/30/2023] Open
Abstract
Spinal tuberculosis is due to globalization no longer a disease limited to developing nations. It remains in Germany a rarity and still a difficult diagnosis. Here we analyzed patients with spinal tuberculosis treated at our neurosurgical department. According to the infected anatomic segment, patients were assigned in one of three groups. Surgery was performed when neurological deficit due to mechanical compression, deformity, instability, severe pain, necrotic bone or failure to respond to anti-tuberculous treatment were observed. We identified 34 patients with spinal tuberculosis who underwent surgical treatment. In the cervical spinal tuberculosis group, there were 15 cases (46.9%) In most cases treatment consisted of spinal instrumentation. In the thoracic group, 10 cases (29.4%) were observed. The treatment was performed by dorsolateral spinal instrumentation. For the thoracolumbar group, 9 cases (26.4%) were observed. In most cases dorsolateral spinal instrumentation was performed. One patient in the first group and one patient in the third group relapsed after operation. A second surgery was necessary. Patients with chronic back pain, immigration background and/or neurological deficit spinal TB should be considered as a differential diagnosis. Combined surgical intervention and medical treatment is associated with a favorable outcome.
Collapse
Affiliation(s)
- Fatma Kilinc
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
| | - Matthias Setzer
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Daniel Jussen
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Florian Geßler
- Department of Neurosurgery, University Medicine of Rostock, Rostock, Germany
| | - Vincent Prinz
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, Goethe University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany
| |
Collapse
|
4
|
Chen L, Liu C, Ye Z, Huang S, Liang T, Li H, Chen J, Chen W, Guo H, Chen T, Yao Y, Jiang J, Sun X, Yi M, Liao S, Yu C, Wu S, Fan B, Zhan X. Predicting Surgical Site Infection Risk after Spinal Tuberculosis Surgery: Development and Validation of a Nomogram. Surg Infect (Larchmt) 2022; 23:564-575. [PMID: 35723640 PMCID: PMC9398487 DOI: 10.1089/sur.2022.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The purpose of this study was to predict the surgical site infection risk after spinal tuberculosis surgery based on a nomogram. Patients and Methods: We collected the clinical data of patients who underwent spinal tuberculosis surgery in our hospital and included all the data in the least absolute shrinkage and selection operator (LASSO) regression analysis. Next, the selected parameters were analyzed using logistic regression. The logistic regression analysis and receiver operating characteristic (ROC) curve analysis were further used to obtain statistically significant parameters. These parameters were then used to construct a nomogram. The C-index, ROC curve, and decision curve analysis (DCA) were used to assess the predictive ability and accuracy of the nomogram, whereas internal verification was used to calculate the C-index by bootstrapping with 1,000 resamples. Results: A total of 394 patients with spinal tuberculosis surgery were included in the study, of whom 76 patients had surgical site infections whereas 318 patients did not. The predicted risk of surgical site infection in the nomogram ranged between 0.01 and 0.98. Both the value of the C-index of the nomogram (95% confidence interval [CI], 0.62–0.76) and the area under the curve (AUC) were found to be 0.69. The net benefit of the model ranged between 0.01 and 0.99. In contrast, the C-index calculated by the internal verification method of the nomogram was found to be 0.68. Conclusions: The risk factors predicting surgical site infection after spinal tuberculosis surgery included albumin, lesion segment, operation time, and incision length.
Collapse
Affiliation(s)
- Liyi Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Chong Liu
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Zhen Ye
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Shengsheng Huang
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Tuo Liang
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Hao Li
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Jiarui Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Wuhua Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Hao Guo
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Tianyou Chen
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Yuanlin Yao
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Jie Jiang
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Xuhua Sun
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Ming Yi
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Shian Liao
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Chaojie Yu
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Shaofeng Wu
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Binguang Fan
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| | - Xinli Zhan
- Spine and Osteopathy Ward, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi Province, China
| |
Collapse
|