Spinal Tuberculosis Abdullah Baghaffar

What Is Spinal Tuberculosis? Tuberculosis of the spine, also known as tuberculous spondylitis or Pott's Disease, is a is an infection of the spine by the Mycobacterium tuberculosis bacterium (TB). It usually infects another area of the body first before moving into the spine. Spinal tuberculosis is rare in industrialized countries but still common in developing nations. It can cause permanent neurological problems and severe spinal deformities, but it can be controlled in most cases.

Symptoms Some of the most common symptoms of Pott's Disease are: –Back pain –Fever –Night sweats –Anorexia This leads to a significant, unhealthy weight-loss. The back pain is sometimes so painful patients will develop a mass in the spine which can cause: –Tingling –Numbness –Weakness in the legs –The deterioration and back pain will cause the sufferer to sit and walk in a rigid, upright manner.

Causes Pott's Disease, like other forms of TB, is caused by a mycobacterium which is spread by way of blood or breathing droplets from an infected person into your lungs where the bacteria will thrive and grow if not killed by your immune system. Once in your blood stream, tuberculosis can infect a number of organs, each with their own set of symptoms and complications.

Diagnosis Tuberculosis causes the disks in the spine to die and break down, which often leads to the narrowing of the vertebra and the eventual collapse of the spine. Radiographs and CT scans of the spine are sometimes able to show tuberculosis of the spine, if present, a bone biopsy will be done for confirmation. A test is often performed to check a patient's Enthrocyte Sedimentation Rate; a high ESR is a sign of Pott's Disease. TB skin tests can also determine if there is a presence of tuberculosis in the body.

How to Treat Spinal TB? Instructions 1.Administer a combination of chemotherapy with at least three antituberculous drugs. A four drug regimen should be used empirically in areas with less than a 4 percent resistance to isonicotinic acid hydrazide (INH). 2.Adjust the treatment as local susceptibility changes. INH and rifampin should be administered during the entire treatment. 3.Provide additional medication during the first two months of therapy. These usually include first line drugs like ethambutol, pyrazinamide and streptomycin. A three drug regimen usually includes INH, rifampin and pyrazinamide. An additional second line drug should be used in cases of drug resistance. 4.Continue antibiotic therapy for six to nine months in patients without cervical lesions, major neurologic involvement or multiple vertebral involvement. These patients are candidates for surgery and may require a shorter period of chemotherapy. 5.Consider surgery to correct spinal deformities. The reconstruction method used depends on the extent of bone destruction and the level of the vertebral spine involved. The most conventional approaches include anterior radical debridement and posterior stabilization with instruments.