Spinal Tuberculosis

• Spinal tuberculosis which is also known as Pott’s disease. It is a spinal infection that tuberculosis causes and can lead to osteomyelitis, spinal mechanical instability, and kyphotic deformity.
• Good knock to diagnose this condition with the help of CT-guided biopsy sent for acid-fast bacilli.
• The treatment-related to this is usually bracing and antituberculosis antibiotics in the absence of neurological defects or some mechanical instability.
• In the presence of neurological deficits, Progressive kyphosis, and mechanical instability, the doctor manages the surgical treatment.

With the help of a neurologist in Ludhiana, you could manage such health conditions without any difficulty.

Epidemiology

• Incidence
  • There has been an increase in the incidence of tuberculosis because of the increasing immunocompromised population demographics.
  • We can see it in the HIV-positive population and especially in those patients with CD4 + counts of 50 to 200.
• Anatomic location
  • Almost 15% of patients with tuberculosis will have extrapulmonary involvement in the spine. You can specifically sit in the thoracic spine, which is the most common extrapulmonary site.
  • Almost 5% of all tuberculosis patients have spine involvement.

The best neurologist will manage to control spinal tuberculosis.

Etiology

• Pathoanatomy
  • Early infection
    • It begins in the metaphysics of the vertebral body.
    • It spreads under the anterior longitudinal ligament and leads to contagious multilevel involvement.
    • Non-contagious segments or skip lesions(15%)
    • Paraspinal abscesses formation (50%).
    • Generally, the anterior can be pretty massive, which is much more common in tuber classes than pyogenic infection.
    • In the beginning, it does not involve the Disc space That distinguishes it from pyogenic osteomyelitis, but the doctor can miss diagnose it as a neoplastic lesion.
  • Chronic infection
    • Severe kyphosis
      • It means deformity in non-operative cases is around 15°. In 5% of patients, the deformity is less than 60°.
      • higher rate of progression of kyphosis when there is an involvement of the vertebral body and posterior elements.
    • dr often diagnose the infection late as there is frequently much more severe chi poses in granulomatous spinal infection then pyogenic infection.
    • In adults
      • Kyphosis stay static after healing of disease
    • In children
      • kyphosis the props in 40% of cases because of growth spurt.
    • Classification of progression
      • Type 2, Reduction in progression with growth.
      • Type 3, there are minimal changes during either active or healed phases.

Symptoms

• Onset of signs of tuberculosis spondylitis are generally more insidious as compared to pyogenic infection. Some of the symptoms include:
  • Constitutional symptoms
  • chronic illness
  • Night sweats
  • Malaise
  • weight loss
  • back pain
    • There is often a lack of symptoms that only occurs after major destruction and deformity.

Physical exams

• Kyphotic deformity
• Neurological deficit which is present in 10 to 47 percent of patients with spinal tuberculosis.
  • Mechanism
    • abscess, Granulation tissue, Caseous tissue, Tubercular debris causes mechanical pressure.
    • Subluxation or dislocation of paraplegia Causes mechanical instability from Healed diseases can occur with severe deformity.
  • Stenosis from ossification of ligamentum flavum adjacent to severe kyphosis.

 Treatment

• Laminectomy
  • Indication
    • Extradural extraosseous granuloma subdural granuloma
    • decompression and myelotomy indications.
    • intramedullary granuloma