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Spinal tuberculosis, aka Pott’s disease or tuberculous spondylitis, is a rare infectious disease that causes the vertebrae to collapse, resulting in kyphosis (hunchback). Pott’s disease, also known as bone tuberculosis, is named after Dr. Percivall Pott, who first described the condition in the 1700s. It begins in the vertebra and slowly spreads to surrounding areas.
What are the causes of Spinal Tuberculosis?
Tuberculosis can easily spread to the spine and cause spinal arthritis if not treated. When the infection spreads to two adjacent joints, the spinal disc receives fewer nutrients and begins to degrade. The vertebrae narrow and collapse when a disc collapses, causing spinal cord damage. This condition can result in nerve damage, paralysis, and back deformities if left untreated. Pott’s disease affects one to two percent of patients with pulmonary tuberculosis.
What are the symptoms of Spinal Tuberculosis?
When a disc ruptures, the vertebrae narrow and collapse, injuring the spinal cord. This condition, if left untreated, can cause nerve damage, paralysis, and back deformities. If the TB spine symptoms go unnoticed and the condition worsens, the patient will struggle to stand and walk properly. Patients gradually experience leg numbness and spine curvature, and leg paralysis may occur in severe cases. Pott’s disease affects one to two percent of pulmonary tuberculosis patients showing the following symptoms.
- Unknown cause of weight loss
- Sweating at night
- Severe back pain indicates that tuberculosis has progressed to the spine.
Diagnosis of Spine Tuberculosis
Any patient exhibiting the above mentioned signs and symptoms and risk factors should be suspected of having spine tuberculosis. A thorough physical examination is performed, with special attention paid to neurological status. For final diagnosis confirmation, the following tests are advised:
In the early stages of the disease, an x-ray will show loss of disc height because spinal tuberculosis usually begins with involvement and destruction of the disc material. In advanced cases, it will also reveal vertebral collapse and spinal deformity.
2. MRI Scan
An MRI is usually performed early in cases where spinal tuberculosis is suspected. It will detail the infection affecting the disc and adjacent vertebral bodies.
A biopsy of the lesion seen on MRI is critical. It will provide us with final confirmation of the lesion’s diagnosis. A microscopic histopathology examination will distinguish between bacterial/tuberculosis infection and a tumor.
4. CT Guided Biopsy
A needle is inserted with CT guidance under local anesthesia, and the required material is retrieved.
5. CT Scan
A CT scan is used to assess bony anatomy in greater detail when an MRI is impossible. A CT scan is also used in postoperative patients to evaluate bone healing.
What is the treatment of Spinal Tuberculosis?
Bone tuberculosis can be fatal if not treated. Treatments for bone tuberculosis include the following:
1. Anti-tuberculosis Medications
The most commonly used anti-tuberculosis drugs are rifampicin, streptomycin, kanamycin, isoniazid, prothionamide, cycloserine, and pyrazinamide. They can enter the cerebrospinal fluid and attack the bacteria. Bone tuberculosis can be cured in 6 to 12 months.
These drugs may be prescribed to prevent complications such as spinal cord or heart inflammation.
If you have advanced bone tuberculosis, you may require surgery to remove an infected portion of your bone.
In developing countries, spinal tuberculosis is a major concern. While the risk is much lower in developed countries, the symptoms should still be avoided. So, if you notice symptoms similar to any of these diseases, don’t hesitate to seek surgical intervention.