300 Section - Multidisciplinary rehabilitation approach for complicated spinal tuberculosis: evaluating functional recovery

Objectives : Spinal tuberculosis (TB) frequently leads to permanent neurological impairment and severe disability. while the WHO`s End TB strategy advocates for integrated, patient centered care, structured rehabilitation remains scarce and is not systematically integrated into TB programs in resource- limited settings like Nepal. This study aims to evaluate the effectiveness of a multidisciplinary rehabilitation program on functional independence and neurological status in patients with complicated spinal TB.

Design: A hospital based, pre-post intervention study is being conducted at the Spinal Injury Rehabilitation Center (SIRC), Nepal. We are enrolling 70 patients with complicated spinal TB. The multidisciplinary rehabilitation intervention is delivered over an 8-12 weeks inpatient period. The primary outcome is functional independence, measured using the Spinal Cord Independence Measure (SCIM) at admission and discharge. Secondary outcomes include SCIM domain scores (self-care, respiration/sphincter management, mobility ) and neurological status graded by the ASIA impairment Scale (AIS). Data analysis will employ paired t-tests (or Wilcoxon signed- rank tests) to compare pre- and post-rehabilitation scores.

Results: We anticipate a statistically significant improvement in the total SCIM score following the rehabilitation intervention. We also expect to observe meaningful improvements across all SCIM domains and a positive shift in AIS grades, indicating neurological recovery. The result will be analyzed by the end of April 2026, and full findings will be presented at the conference.

Conclusion: This study will generate crucial evidence on the impact of structured rehabilitation for complicated spinal TB in a low-resource setting. The findings are expected to support the development of context-specific guidelines and advocate for the integration of rehabilitation as a core component of spinal TB management in Nepal, ultimately aiming to improve long term functional outcomes and quality of life for survivors.