Transcript Spinal Tuberculosisx

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.