• Jin-tao Qu, Yu-quan Jiang, Guo-hua Xu, Yu Tang, Zi-tian Wang, Xiao-jian Ye, Guo-hua Shi, Ji-wu Dong, Jian Li, Jin-lin Zhou, and Yue Hu.
• Department of Orthopedics, No. 44 Hospital, #64 Huanghe RD, 550009, Guiyang, Guizhou, China.
• World Neurosurg. 2015 May 1;83(5):700-7.

ObjectiveTo present the clinical characteristics and prognostic factors of neurologic recovery in patients with cervical spinal tuberculosis (CST).MethodsGeneral description and multivariate analysis were used to detect possible predictors of the outcome of patients with neurologic deficit. Follow-up data were used to generate a Kaplan-Meier curve of neurologic recovery.ResultsProtective factors in neurologic recovery included less involved vertebrae, surgery, and higher Japanese Orthopaedic Association score before treatment; not shorter symptom duration was not a protective factor. Normal neurologic function was present in 30% of patients 6 months after treatment, in 56% of patients 12 months after treatment, and in 93% of patients 28 months after treatment. The cumulative complete neurologic recovery rates at 6 months, 12 months, and 28 months were 44%, 68%, and 91.7% in the surgery group and 16.7%, 38.8%, and 94.4% in the nonsurgery group.ConclusionsSurgery and Japanese Orthopaedic Association score before treatment are important predictors of neurologic recovery in patients with CST. A neurologic recovery curve could predict neurologic recovery in patients with CST and indicate in patients with neurologic deficit how long it will take to achieve complete neurologic recovery. The effect of surgery is quick, and the effect of conservative treatment is slower, but no difference in neurologic recovery was found in the long-term. Conservative treatment should be tried in every patient with CST with no obvious indication for surgery. In contrast to patients with tuberculosis without cervical spine involvement but with more complications, comprehensive conservative therapy should be preferred for patients with neurologic deficit to avoid unnecessary surgery and overtreatment and to conserve medical resources. Indications for surgical intervention for CST should be carefully selected.Copyright © 2015 Elsevier Inc. All rights reserved.

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