Epidemiological and clinical review of spinal Tuberculosis at a Regional Orthopaedic Hospital in Nigeria

Purpose Spinal tuberculosis (TB) remains a major cause of morbidity in low- and middle-income countries. This study evaluated the epidemiological profile, management strategies, and neurological outcomes of spinal TB at a tertiary orthopaedic centre in Nigeria. Methods A retrospective review of patients treated between January 2021 and October 2025 was conducted. Diagnosis was based on clinical, radiological, microbiological, or histopathological criteria. Demographic and neurological data using the ASIA impairment scale were extracted. Changes in neurological status between presentation and final follow-up were analysed using the Wilcoxon signed-rank test, with significance set at p Results A total of 223 patients were identified; 61% were male (n = 137) with a mean age of 45.2 years (range 4-81). All patients received anti-tuberculous therapy. Non-operative management was undertaken in 203 patients (91%), while 20 patients (9%) underwent adjunctive surgery for neurological deficit, instability, or deformity. Among conservatively managed patients with documented orthopaedic follow-up (n = 95), 75 presented with neurological deficits; 62 (82.7%) improved by at least one ASIA grade, including 51 (68.0%) who recovered to ASIA E (median improvement D to E; p Conclusion Protocol-driven spinal TB management combining universal chemotherapy with selective surgery yields favourable neurological outcomes in endemic resource-limited settings.