Hubungan Kadar Interleukin 6 dan TNF Alpha Pre dan Post Operatif Spondilitis TB di RSUP Haji Adam Malik Medan Tahun 2023

Abstract

Background. Tuberculosis (TB) spondylitis, also known as Pott's disease, is a bone infection caused by Mycobacterium tuberculosis. It is an extrapulmonary form of tuberculosis with high morbidity that can lead to severe functional impairments. Extrapulmonary TB accounted for 14% of reported global TB cases in 2017. Indonesia ranked fourth in TB incidence in 2011, following India, China, and South Africa. TB affects the musculoskeletal system, with nearly 50% of cases affecting the spine. The clinical manifestations of TB spondylitis develop slowly, often presenting as nonspecific back pain. The gold standard diagnosis of the disease can be carried out using histopathologic examination. Monitoring IL-6 levels during TB treatment could serve as a potential biomarker for prognosis. Elevated IL-6 levels at the initial stages of TB correlate with a higher bacterial load and worsening infection outcomes while decreasing levels may indicate a weakening Th1 immune response. Monitoring IL-6 levels during anti-TB therapy could aid in assessing treatment success. Method. This is an analytical study using cross-sectional study approach to evaluate the relationship between pre- and post-operative IL-6 and TNF-alpha levels in TB spondylitis in Haji Adam Malik Central General Hospital who underwent surgical intervention due to TB spondylitis from 2023. Consecutive sampling was used as the sampling technique in this study. Results. Based on age, majority of subjects were on group age > 30 years, totaling 27 people (65.7%), based on gender, majority of subjects were male (22 samples or 55%), while based on BMI, majority of subjects had obesity, accounting for 16 people (72.7%). The mean Interleukin 6 level in the preoperative group was 58.86 pg/dL (SD = 7.30 pg/dL) while in the postoperative group mean was 42.23 pg/dL (SD = 4.41 pg/dL). The mean TNF-α level in the preoperative age group was 16.55 mg/dL (SD = 4.04 mg/dL) while in the postoperative group with a higher mean of 18.68 mg/dL (SD = 5.69 mg/dL). Pearson correlation test showed a significant relationship/correlation was found between interleukin 6 levels and TNF-α (p=0.008) with correlation value (r) is 0.54. There was a significant correlation between interleukin 6 and TNF-α levels (p=0.001) with Pearson correlation test. Conclusion. preoperative TB spondylitis cases had significantly higher levels of IL-6, and TNFα than postoperative group. This may contribute to the increased risk of TB spondylitis in the preoperative group. In addition, the difference in TNF-α levels between the two groups was not statistically significant. Lastly, there was a significant positive correlation between IL-6 and TNF-α levels in both preoperative and postoperative groups, however, there was no significant correlation between IL-6 and TNF-α levels in both groups.