TY - JOUR
T1 - The epidemiology of spinal tuberculosis in the United States
T2 - An analysis of 2002-2011 data
AU - De La Garza Ramos, Rafael
AU - Goodwin, C. Rory
AU - Abu-Bonsrah, Nancy
AU - Bydon, Ali
AU - Witham, Timothy F.
AU - Wolinsky, Jean Paul
AU - Sciubba, Daniel M.
N1 - Funding Information:
Dr. Sciubba has consulting relationships with Medtronic, Globus, DePuy Synthes, and Orthofix. Dr. Goodwin is a UNCF (United Negro College Fund)/Merck Postdoctoral Fellow and has received an award from the Burroughs Wellcome Fund and the Johns Hopkins Neurosurgery Pain Research Institute. Dr. Bydon received support of a non-study-related clinical or research effort that he oversaw from DePuy Spine, and he is on the advisory board for MedImmune. Dr. Witham received support of a non-study-related clinical or research effort that he oversaw from Eli Lilly and Co. and from the Gordon and Marilyn Macklin Foundation. Dr. Wolinsky is a consultant for Medtronic, DePuy Synthes, Globus, Orthofix, and Stryker.
Publisher Copyright:
©AANS, 2017.
PY - 2017/4
Y1 - 2017/4
N2 - OBJECTIVE: The aim of this study was to investigate the incidence of spinal tuberculosis (TB) in the US between 2002 and 2011. METHODS: The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify patients with a discharge diagnosis of TB and spinal TB. Demographic and hospital data were obtained for all admissions, and included age, sex, race, comorbid conditions, insurance status, hospital location, hospital teaching status, and hospital region. The incidence rate of spinal TB adjusted for population growth was calculated after application of discharge weights. RESULTS: A total of 75,858 patients with a diagnosis of TB were identified, of whom 2789 had a diagnosis of spinal TB (3.7%); this represents an average of 278.9 cases per year between 2002 and 2011. The incidence of spinal TB decreased significantly - from 0.07 cases per 100,000 persons in 2002 to 0.05 cases per 100,000 in 2011 (p < 0.001), corresponding to 1 case per 2 million persons in the latter year. The median age for patients with spinal TB was 51 years, and 61% were male; 11.6% were patients with diabetes, 11.4% reported recent weight loss, and 8.1% presented with paralysis. There were 619 patients who underwent spinal surgery for TB, with the most common location being the thoracolumbar spine (61.9% of cases); 50% of patients had instrumentation of 3 or more spinal segments. CONCLUSIONS: During the examined 10-year period, the incidence of spinal TB was found to significantly decrease over time in the US, reaching a rate of 1 case per 2 million persons in 2011. However, the absolute reduction was relatively small, suggesting that although it is uncommon, spinal TB remains a public health concern and most commonly affects male patients approximately 50 years of age. Approximately 20% of patients with spinal TB underwent surgery, most commonly in the thoracolumbar spine.
AB - OBJECTIVE: The aim of this study was to investigate the incidence of spinal tuberculosis (TB) in the US between 2002 and 2011. METHODS: The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify patients with a discharge diagnosis of TB and spinal TB. Demographic and hospital data were obtained for all admissions, and included age, sex, race, comorbid conditions, insurance status, hospital location, hospital teaching status, and hospital region. The incidence rate of spinal TB adjusted for population growth was calculated after application of discharge weights. RESULTS: A total of 75,858 patients with a diagnosis of TB were identified, of whom 2789 had a diagnosis of spinal TB (3.7%); this represents an average of 278.9 cases per year between 2002 and 2011. The incidence of spinal TB decreased significantly - from 0.07 cases per 100,000 persons in 2002 to 0.05 cases per 100,000 in 2011 (p < 0.001), corresponding to 1 case per 2 million persons in the latter year. The median age for patients with spinal TB was 51 years, and 61% were male; 11.6% were patients with diabetes, 11.4% reported recent weight loss, and 8.1% presented with paralysis. There were 619 patients who underwent spinal surgery for TB, with the most common location being the thoracolumbar spine (61.9% of cases); 50% of patients had instrumentation of 3 or more spinal segments. CONCLUSIONS: During the examined 10-year period, the incidence of spinal TB was found to significantly decrease over time in the US, reaching a rate of 1 case per 2 million persons in 2011. However, the absolute reduction was relatively small, suggesting that although it is uncommon, spinal TB remains a public health concern and most commonly affects male patients approximately 50 years of age. Approximately 20% of patients with spinal TB underwent surgery, most commonly in the thoracolumbar spine.
KW - Epidemiology
KW - Incidence
KW - Infection
KW - Pott's disease
KW - Spine
KW - Surgery
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85016923926&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85016923926&partnerID=8YFLogxK
U2 - 10.3171/2016.9.SPINE16174
DO - 10.3171/2016.9.SPINE16174
M3 - Article
C2 - 27982765
AN - SCOPUS:85016923926
SN - 1547-5654
VL - 26
SP - 507
EP - 512
JO - Journal of Neurosurgery: Spine
JF - Journal of Neurosurgery: Spine
IS - 4
ER -