Tuberculosis of Spine

Tuberculosis of spine (also known as Pott’s disease) is the most important disease that affects the spine. Spinal tuberculosis is the most dangerous form of tuberculosis and comprises about 2% of the total tubercular population. The condition affects the children and adolescents more as compared to adults.

Since the advent of anti-tubercular drugs and improved health measures, the spinal tuberculosis has become a rare occurrence in the developed countries.

Tuberculosis Symptoms

In the prodromal stage, the patient gets easily tired and complains of loss of weight and evening rise of temperature. Pain is usually the main complaint, which is slight in the beginning and dull in character. The pain becomes worse on walking. Pain may be localized or referred.

The next complaint is rigidity, which restricts all spinal movements. Deformity may also result in the form of a lump or kyphosis, leading to hunchback. The changes may extend over several spinal segments and the infected vertebrae may collapse leading to severe kyphosis called Gibbus.

Clinical Examination

On palpation, there is localized tenderness over the affected area of the spine. Any deformity is also easily palpable. Movements become decreased in all directions. Any attempt to movement provokes the muscular spasm. Special tests include coin test and fluctuation test. Legs must also be examined for presence of any neurological deficits.

X-ray shows diminished intervertebral spaces with destruction of adjacent structures.

Treatment: Treatment regime involves immobilizing the spine along with anti-tubercular therapy. Avoid weight bearing in advanced cases.

In advanced cases, surgery is done, which includes bone grafting or drainage of the abscess.

Enema may be given for constipation and all efforts must be put in so as to prevent the development of bedsores.

Complications of Spinal TB

These may include para-vertebral abscess, meningitis, pulmonary tuberculosis infection, renal stones or paraplegia (due to compression of the spinal cord).