what is spine TB.?

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Introduction

Tuberculosis (TB) of the spine (Pott’s disease) is the most common site of bone infection in TB; hips and knees are also often affected. The lower thoracic and upper lumbar vertebrae are the areas of the spine most often affected.

Pathogenesis Of Pott’s Disease

Pott’s disease results from haematogenous spread of tuberculosis from other sites, often pulmonary. The infection then spreads from two adjacent vertebrae into the adjoining disc space. If only one vertebra is affected, the disc is normal, but if two are involved the intervertebral disc, which is avascular, cannot receive nutrients and collapses. The disc tissue dies and is broken down by caseation, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage). A dry soft tissue mass often forms and superinfection is rare.
Diagnosis of Pott’s disease
Clinical

The disease progresses slowly. Signs and symptoms include:

* Localised back pain
* Paravertebral swelling may be seen
* Systemic signs and symptoms of TB may be present
* Neurological signs may occur, leading to paraplegia.

Microbiology

* Needle biopsy of bone or synovial tissue. Numbers of tubercle bacilli present are usually low but are pathognomonic.
* Acid-fast stain and culture for Mycobacterium tuberculosis, plus fungi and other pathogens, should be performed.

Imaging

* Spinal x-ray may not show early disease as 50% of bone mass must be lost for changes to be visible on x-ray. However, plain radiographs can show vertebral destruction and narrowed disc space.
* MRI is useful to demonstrate the extent of spinal compression and can show changes at an earlier stage than plain radiographs. Bone elements visible within the swelling, or abscesses, are strongly indicative of Pott’s disease as opposed to malignancy.
* CT scans and nuclear bone scans can also be used.

Management of Pott’s disease

Drug treatment is generally sufficient for Pott’s disease, with spinal immobilisation if required. Surgery is required if there is spinal deformity or neurological signs of spinal cord compression.

Standard antituberculosis treatment is required.

Duration of antituberculosis treatment:

* If debridement and fusion with bone grafting are performed, treatment can be for six months
* If debridement and fusion with bone grafting are NOT performed a minimum of 12 months’ treatment is required.

Pathogenesis of Pott’s disease

Pott’s disease results from haematogenous spread of tuberculosis from other sites, often pulmonary. The infection then spreads from two adjacent vertebrae into the adjoining disc space. If only one vertebra is affected, the disc is normal, but if two are involved the intervertebral disc, which is avascular, cannot receive nutrients and collapses. The disc tissue dies and is broken down by caseation, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage). A dry soft tissue mass often forms and superinfection is rare.

Signs and symptoms by site of infection

Pulmonary TB

Fever, productive cough, anorexia, fatigue and night sweats.

Tuberculous meningitis

Headache (intermittent or persistent for 2–3 weeks). Confusion or other subtle changes in mental status. Fever may be low grade or absent. Patient may progress to coma over a few days or weeks.

Skeletal TB (most common is the spine; Potts’ disease)

Pain and stiffness which may lead to paralysis of the lower limbs.

Tubercular arthritis is usually a monoarthritis affecting primarily the hip or knee and less commonly the ankle, elbow, wrist and shoulder.
Pott's disease
From Wikipedia, the free encyclopedia.

Pott's disease is a presentation of extrapulmonary tuberculosis that affects the spine. Precisely it is called tuberculous spondylitis and the original name was formed after Percivall Pott, a London surgeon. It is most commonly localized in the thoracic portion of the spine.

Common signs and symptoms are:

* back pain
* fever
* night sweats
* anorexia
* weight loss

Diagnosis is based on:

* blood tests - elevated ESR
* skin tests
* radiographs of the spine
* bone scan
* CT of the spine
* bone biopsy

Late complications of the disease are:

* severe kyphosis
* sinus formation,
* paraplegia (so called Pott's paraplegia)

Treatment:

* non-operative - antituberculous drugs
* immobilization of the spine region
* operative

Other Answers:
Tuberculosis bacteria can spread to other parts of the body. While the disease is most commonly found in the lungs, it is also sometimes found in other parts of the body like the spine.

Pott's disease is a presentation of extrapulmonary tuberculosis that affects the spine, a kind of tuberculous arthritis of the intervertebral joints. More precisely it is called tuberculous spondyloarthropathy and the original name was formed after Percivall Pott (1714-1788), a London surgeon. It is most commonly localized in the thoracic portion of the spine. The fictional Hunchback of Notre Dame had a gibbous deformity (humpback) that is thought to have been caused by tuberculosis.

Pott's disease is tuberculosis of the spine, where any vertebra may be involved but particularly the lower thoracic and the upper lumbar regions are affected

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what is spine TB.?

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