Abstract
BACKGROUND: Spinal TB (STB) is paucibacillary form of disease caused by Mycobacterium Tuberculosis. Late diagnosis of STB can lead to significant disability and morbidity. There is limited data available on diagnostic yield of CT guided biopsy/ultrasonography guided aspiration by various laboratory tests (phenotypic and molecular) used in evaluation STB. METHODS: Present study was conducted in Department Orthopaedics and Pathology at tertiary care centre in Delhi. Total 68 clinico-radiologically suspected cases undergoing percutaneous aspiration (CT/USG guided) were included in the study. The aspirated tissue/pus was sent for cytology/histopathology/culture/molecular tests. Diagnostic yield of CT/USG guided aspiration for various phenotypic (histopathology/cytology/AFB smear) and molecular tests (CBNAAT/LPA) was calculated alone and in various combination. pvalue <0.05 was considered significant. RESULTS: AFB smear had the lowest diagnostic yield in both USG and CT guided aspirate (28 % and 17.2 % respectively). Histology/cytology combination with molecular method had 100 % diagnostic yield similar to all tests combined. CONCLUSION: Diagnosis of STB was ascertained in all cases using the combination of molecular methods and phenotypic tests and no single test is effective in ascertaining the diagnosis. The tissue obtained by percutaneous CT guided biopsy/USG guided aspiration technique is adequate to submit tissue to all tests to ascertain diagnosis.