Introduction: Spinal tuberculosis (TB) is a known cause of spinal deformity and paraplegia. However, there is limited data on the prevalence of Pott’s disease in the United States.

Methods: The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify patients with a discharge diagnosis of TB and spinal TB. Demographic and hospital data was obtained for all admissions, which included age, gender, race, comorbid conditions, insurance status, hospital location, hospital teaching status, and hospital region. The population growth-adjusted incidence rate of spinal TB was calculated after application of discharge weights.

Results: A total of 75,858 patients with a diagnosis of TB were identified, out of whom 2,789 had a diagnosis of spinal TB (3.7%); an average of 278.9 cases per year between 2002 and 2011. The incidence of spinal TB decreased significantly from 0.07 cases per 100,000 persons in 2002 to 0.05 cases per 100,000 in 2011 (p<0.001), corresponding to 1 case per 2 million persons in the latter year. The median age for patients with spinal TB was 51 years, and 61% were male; 11.6% were diabetics, 11.4% reported recent weight loss, and 8.1% presented with paralysis. There were 619 patients who underwent spinal surgery for TB, with the most common location being the thoracolumbar spine (61.9% of cases); 50% of patients had instrumentation of 3 or more spinal segments.

Conclusions: During the examined 10-year period, the incidence of spinal TB was found to significantly decrease over time in the United States, reaching a rate of 1 case per 2 million persons in 2011. Though uncommon, spinal TB remains a public health concern, most commonly affecting male patients around 50 years of age. Approximately 20% of patients with spinal TB underwent surgery, most commonly in the thoracolumbar spine.

Patient Care: Though uncommon, spinal TB remains a public health concern in developed countries. Knowledge of its incidence may encourage physicians to include the disease in the differential of patients with risk factors for TB

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the incidence of spinal tuberculosis (TB) in the United States between 2002 and 2011

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