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SPINAL TUBERCULOSIS: A REVIEW

ADVISOR

dr. Fadhil
dr. Prori
dr. Herbert

SUPERVISOR
dr. Notinas Horas,M Kes, Sp.OT

ORTHOPEDIC AND TRAUMATOLOGY DEPARTMENT
HASANUDDIN UNIVERSITY
2014
Ravindra Kumar Garg, Dilip Singh Somvanshi
Chhatrapati Shahuji Maharaj Medical University, Lucknow, Uttar Pradesh, India

INTRODUCTION
Spinal tuberculosis is one of the oldest diseases known
to mankind and has been found in Egyptian mummies
dating back to 3400 BC. The disease is popularly
known as Potts spine. The classic destruction of the
disk space and the adjacent vertebral bodies,
destruction of other spinal elements, severe and
progressive kyphosis subsequently became known as
Potts disease


The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

EPIDEMIOLOGY
Tuberculosis is a disease of poverty that affects
mostly young adults in their most productive years.
In 2009, approxi- mately 1.2 million new
tuberculosis cases were reported among people
living with HIV.


The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

PATHOGENESIS
Spinal involvement is usually a result of
hematogenous spread of M. tuberculosis into the
dense vasculature of cancellous bone of the
vertebral bodies

The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

CLINICAL FEATURES
The characteristic clinical features of spinal
tuberculosis include local pain, local tenderness,
stiffness and spasm of the muscles, a cold
abscess, gibbus, and a prominent
spinal deformity. The cold abscess slowly
develops when tuberculous infection extends to
adjacent ligaments and soft tissues. Cold abscess
is characterized by lack of pain and other signs
of inflammation

The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

CLINICAL FEATURES
The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

DIAGNOSIS
Diagnosis of spinal tuberculosis depends on
presence of characteristic clinical and
neuroimaging findings.

The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

IMAGING
Plain radiographs
Computed tomography
MRI
Bone scan
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CITOLOGY AND MICROBIOLOGY
Acid fast bacilli
PCR
Erythrocyte sedimentation rate

The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

DIFFERENTIAL DIAGNOSIS
ommon differential diagnosis includes pyogenic
spondylitis, brucellar spondylitis, sarcoidosis,
metastasis, multiple myeloma, and lym- phoma


The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

TREATMENT
Antituberculous treatment
Supportive measures
Surgery
The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

PROGNOSIS
Various studies show that 8295% cases respond
to medical treatment alone in the form of pain
relief, improving neurological deficit, and
correction of spinal deformity

The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5

CONCLUSION
Medical treatment is generally effective. Surgical
intervention is necessary in advanced cases with
marked bony involvement, abscess for- mation,
or paraplegia.
The Journal of Spinal Cord Medicine 2011 VOL. 34 NO. 5