Cervical Spine Tuberculosis: A Systematic Review and Meta-Analysis of Epidemiology, Clinical Presentation, Diagnosis, Management, and Outcomes.

BACKGROUND: Spinal tuberculosis is the most common form of extra pulmonary tuberculosis. While cervical involvement, known as cervical Pott's disease, has traditionally been considered rare, its incidence is increasing. However, comprehensive data on its clinical presentation, diagnostic methods, treatment options, and outcomes remain limited. This review consolidates evidence on cervical spine tuberculosis, offering insights into its epidemiology, therapeutic strategies, and outcomes.

METHODS: A systematic search of PubMed/MEDLINE and Google Scholar was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies related to cervical spine tuberculosis. Quantitative data were analyzed using Jamovi 2.3.0.

RESULTS: The pooled mean age was 23.6 years (95% confidence interval: 18.3-29.0), with 54.6% of patients being male. Prior pulmonary tuberculosis and exposure were reported in 52% and 26% of cases, respectively. Common symptoms included cervical pain (69.5%), radicular pain (31%), motor-sensory deficits (46.2%), and fever (50.1%). Magnetic resonance imaging findings showed epidural/paravertebral abscesses with cord involvement in 72.9% of cases. Lesions affected a single vertebral level in 42.8% of cases, predominantly in the upper cervical spine (52.7%). Surgical intervention was performed in 71.9% of patients, using anterior (60.4%), posterior (44.1%), or combined approaches (18.2%). Bone fusion was achieved in 4.1 months. Surgery-related mortality was 1.0%.

CONCLUSIONS: Cervical spine tuberculosis, though rare, is a severe extrapulmonary form with a rising incidence. The condition leads to neurological impairments and spinal deformities, with symptoms including cervical pain, motor-sensory deficits, and fever. A combination of medical and surgical treatment can result in favorable neurological outcomes. Future research should focus on developing protocols and evaluating outcomes to improve management.