TB of spine could prove disastrous, warn doctors

Although tuberculosis (TB) of the lungs is common, TB of the spine is equally a cause for concern, warned city doctors.
Talking to reporters on Thursday on the occasion of the World Tuberculosis Day, Dr Rajasekaran, the president of Association of Spine Surgeons of India (ASSI) and Dr Rajesh Parasnis, consultant spine surgeon, Oyster and Pearl Hospital Pune, said TB of the spine could have disastrous and often irreversible complications.

TB of the spine is referred to as Pott’s disease, or tuberculosis spondylitis. Nearly 1.5 lakh people in India suffer from it.
Dr Parasnis said the symptoms for TB of the spine are back pain, low-grade fever, a hump in the back and in worst cases, paralysis of the limbs. “The TB bacteria invade the vertebrae and induce the destruction of bones of the spine, resulting in pus formation and instability of the spine and appearance of a deformity of the back,” he added.

Tuberculosis spondylitis often causes damage to the spine. It can result in the collapse of vertebrae and fracturing of the bones. Abscesses and tissue formation can narrow the spinal canal, leading to neurological damage. 

In advanced untreated cases, this can lead to compression of the spinal cord resulting in complete paralysis of both legs and rarely, upper limbs. 

“Once the patient reaches the stage of paralysis, even with good surgical treatment, the recovery from paralysis may not always be possible,” added Dr Rajasekaran.  The ASSI and Indian Medical Association (IMA) have joined hands to educate people on the prevention and treatment of spinal problems. This is
supported by India Medtronic. 

There are several ways to diagnose spinal TB. The doctor tests the range of motion in the spine. A series of neurological tests may be conducted and a complete medical history is necessary to diagnose the disease. Blood tests and X-rays can be used to confirm it. Sometimes, magnetic resonance images (MRIs) and bone scans are also necessary.

Patients who have developed a deformity or weakness will need surgical treatment for its correction. A surgery for TB of the spine is complex and carries a risk of complications and chances from the recovery of paralysis are poor.