Neurological Recovery Following Surgical Treatment of Spinal Tuberculosis: A Prospective Cohort Study

Mutaleeb Shobode*

Background: Surgical treatment of spinal tuberculosis has been shown to improve neurological and radiological outcomes; however, the extent to which these improvements translate into clinically meaningful recovery remains unclear. The determinants of such recovery, particularly the role of preoperative neurological status, are not well defined. 

Methods: Fifty-two patients with spinal tuberculosis undergoing surgical treatment at a tertiary referral center were prospectively followed. Patient-reported outcomes were assessed using the Oswestry Disability Index (ODI) and the 36-Item Short Form Health Survey (SF-36). Clinically meaningful improvement was defined using established MCID thresholds (ODI ≥12.8; SF-36 ≥2.7). 

Results: The mean improvement in ODI was 28.4 ± 5.5 points, with all patients (100%) achieving MCID. The mean improvement in SF-36 was 11.1 ± 5.2 points, with 92.3% achieving MCID. Neurological improvement of at least one ASIA grade occurred in 96.2% of patients, while 3.8% experienced deterioration. All patients with preoperative ASIA D achieved complete recovery to ASIA E, whereas patients with ASIA C demonstrated heterogeneous outcomes and accounted for all cases of deterioration. On multivariable analysis, preoperative ASIA grade C was independently associated with lower odds of achieving SF-36 MCID (OR 0.03, 95% CI 0.001–0.88; p = 0.042). Radiological parameters, including kyphotic angle and vertebral involvement, were not independently associated with clinically meaningful recovery.

Conclusion: Surgical treatment of spinal tuberculosis results in high rates of clinically meaningful functional and neurological recovery. However, improvement in overall quality of life is not universal and is primarily determined by preoperative neurological status. 

Level of Evidence: II 

Keywords:

Published on: Jul 1, 2026 Pages: 1-8

Full Text PDF Full Text HTML DOI: 10.17352/ijsr.000027
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