EPIDEMIOLOGICAL PROFILE OF SPINAL TUBERCULOSIS AND TREATMENT PERFORMED IN A SUS REFERENCE SERVICE FROM 2005 TO 2024

UETA, RENATO HIROSHI SALVIONI; FRANçA FILHO, ALEXANDRE FELIPE; HAUACHE NETO, HASSAN AHMAD; LEONEL, MARIA BEATRIZ PINHEIRO; VIEIRA, FáBIO ANTôNIO

doi:10.1590/S1808-185120262501295091

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ORIGINAL ARTICLE BASIC SCIENCES • Coluna/Columna 25 (1) • 2026 • https://doi.org/10.1590/S1808-185120262501295091 linkcopy

EPIDEMIOLOGICAL PROFILE OF SPINAL TUBERCULOSIS AND TREATMENT PERFORMED IN A SUS REFERENCE SERVICE FROM 2005 TO 2024

PERFIL EPIDEMIOLóGICO DA TUBERCULOSE VERTEBRAL E TRATAMENTO REALIZADO EM UM SERVIçO DE REFERêNCIA DO SUS NOS ANOS DE 2005 A 2024

PERFIL EPIDEMIOLóGICO DE LA TUBERCULOSIS VERTEBRAL Y TRATAMIENTO REALIZADO EN UN SERVICIO DE REFERENCIA DEL SUS DE 2005 A 2024

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: To detail the epidemiological profile, clinical presentation, and treatment approach for patients diagnosed with spinal tuberculosis treated at the Department of Orthopedics and Traumatology of UNIFESP - Hospital São Paulo.

Methods: This was an observational, descriptive, and retrospective study conducted with patients diagnosed with spinal tuberculosis between 2005 and 2024 at the Department of Orthopedics and Traumatology of the Universidade Federal de São Paulo/Paulista School of Medicine (UNIFESP).

Results: The study evaluated 29 patients with spinal tuberculosis, with a mean age of 43.28±19.48 years, predominantly male (65.5%), over 50 years old (37.9%), of mixed ethnicity (58.6%), single (55.2%), with incomplete primary education (48.3%), and residing in the countryside of São Paulo (44.8%). Most were retired (28.0%) or students (10.0%). Regarding comorbidities, 34.6% had preexisting diseases, mainly infectious, metabolic/endocrine conditions, and substance use (13.8% each), while 24.1% were smokers. The thoracic segment was the most affected (48.3%), with moderate kyphosis (20° to 40°) in 34.5% of cases. Diagnosis was predominantly through surgical biopsy (44.8%), and clinical treatment was the most commonly adopted approach (55.2%). In the preoperative Frankel classification, 31.0% had no recorded information, while grades E (28.0%) and D (21.0%) were the most frequent. In the postoperative period (n = 13), 42.0% lacked classification records, with grade E (33.0%) being the most prevalent.

Conclusions: Spinal tuberculosis presents an epidemiological profile associated with specific socioeconomic and clinical factors, requiring early diagnosis and a multidisciplinary approach to optimize therapeutic and functional outcomes. Level of Evidence II; Retrospective Study.

Keywords:
Tuberculosis; Spinal; Diagnosis; Disease Management; Epidemiology.

Variables	n	%	Mean ± Standard Deviation
Gender
Female	10	34.5
Male	19	65.5
Age Range
< 30 years	6	20.7	43.28±19.48
31 to 50 years	12	41.4
> 50 years	11	37.9
Ethnicity
White	5	17.2
Brown	17	58.6
Black	6	20.7
Indigenous	1	3.4
Marital Status
Single	16	55.2
Married/Partner	6	20.7
Divorced	1	3.4
Widowed	6	20.7
Education
Illiterate	3	10.3
Incomplete elementary	14	48.3
Complete elementary	3	10.3
Complete high school	5	17.2
Not reported	4	13.8
Origin
São Paulo	12	41.4
Other cities in the state	13	44.8
Not reported	4	13.8

Variables	n	%
Presence of Comorbidity
Yes	10	34.6
No	6	20.7
Not reported	13	44.8
If yes, which Comorbidity(ies)?*
Infectious diseases (HIV, hepatitis C, syphilis)	4	13.8
Respiratory diseases (Asthma, COPD)	2	6.9
Metabolic/endocrine diseases (DM, hypothyroidism, adrenal insufficiency)	4	13.8
Cardiovascular/renal diseases (HTN, heart failure, CKD, kidney transplant)	2	6.9
Substance use (smoking, alcoholism, cocaine, marijuana)	4	13.8
Smoking
Yes	7	24.1
No	9	31.0
Not reported	13	44.8

Variables	n	%
Affected Spinal Segment
Thoracic	14	48.3
Cervical	1	3.4
Lombar	4	13.8
Thoracolumbar	10	34.5
Presence of Kyphosis
Mild (<20°)	6	20.7
Moderate (20° to 40°)	10	34.5
Severe (>40°)	5	17.2
Not reported	8	27.6
Type of Biopsy
Surgical	13	44.8
Percutaneous	9	31.0
Not performed	7	24.1
Treatment Performed
Clinical	16	55.2
Surgical + Clinical	13	44.8
Specified Treatment*
RIPE	14	48.3
Surgical (arthrodesis, corpectomy, spinal decompression, cleaning/reconstruction) combined with RIPE	10	34.5
Surgical (arthrodesis, spinal decompression) without RIPE	3	10.3
Not reported	4	13.8

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Only the number of patients who presented comorbidities was considered (n=13); and each patient may have presented more than one comorbidity.Source: Author.