Tuberculosis of spine

Tuberculosis of spine

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■ Synonyms:

Tuberculous spondylitis, Tuberculosis of spine, Tuberculous spondylitis, Pott's disease

■ Definitions:

Called Pott's disease, is a chronic inflammatory disease of the spine caused by Mycobacterium tuberculosis.

Extrapulmonary tuberculosis accounts for 10 to 15% of total tuberculosis, 10% of which is tuberculosis of osteoarthritis, and 50% of osteoarthritic tuberculosis is tuberculosis. ~ 60% are spinal tuberculosis.

■ Symptom:

It usually develops slowly, with systemic symptoms such as anorexia, weight loss, low fever, fatigue, and loss of appetite. The lesion is painful when pressed, and pain and muscle tension cause spinal restriction and spinal stiffness. As the lesion progresses, vertebral deformation, especially posterior vertebral deformation, is induced and abscess forms along the site. In lumbar spine tuberculosis, along with the jangyang muscles, the abscess can be formed by forming the abscess or abscess and the subcutaneous abscess.

Spinal tuberculosis may be accompanied by paraplegia of the spine as the spinal lesion progresses, which is called Pott paraplegia. Pott paralysis is one of the most serious complications of spinal tuberculosis and occurs in about 10-30%. The middle part of the thoracic or upper part of the tuberculosis occurs well in the middle of the thoracic spine is narrower than the spinal cord in the middle of the thoracic spine is supplied to the spinal cord is relatively lack of blood flow.

Neurologic symptoms are the first appearance of a metacarpal joint in the ankle joint, followed by the following movement paralysis, followed by sensory neuropathy. Pott's syndrome is the most common symptom of spinal tuberculosis. Pott syndrome is the most common symptom in patients with spinal tuberculosis. However, recent treatment with Pott syndrome is associated with Pott syndrome. Patients are rare.

■ Causes / Pathophysiology:

Spinal tuberculosis is caused by infection with Mycobacterium tuberculosis. The first lesion starts in the spinal column. As the tuberculosis progresses slowly, local bone destruction and atrophy develop, and the weakened vertebral body is further depressed by the compressive force and gradual posterior angular deformity appears.

The cold abscess developed in the lesion is initially present only in the vertebral body, but the vertebrae breaks down and breaks down to the anterior or posterior direction. The abscess that is pushed forward forms a periosteum abscess under the appendicitis, , And subcutaneous abscesses or bladder abscess fistulas may be formed, and the abscesses that are pushed backward may block the arteries supplying the spinal cord or may directly affect the spinal cord and cause neurological symptoms.

■ Diagnosis:

Clinical symptoms, radiographs, and clinical tests can be used to make a diagnosis. Blood tests show increased leukocyte counts and increased blood sedimentation rates.

Bone scintigraphy is helpful in confirming the presence or absence of early vertebral lesions. CT scans, magnetic resonance imaging (MRI) are used to determine the extent and extent of vertebral fractures, changes in surrounding soft tissue, presence of cold abscesses, It is often used because it gives decisive information.

■ Progress / Prognosis:

Early treatment is recommended because tuberculous spondylitis may cause paraplegia and progressive posterior horn deformity when left untreated.

■ Complications:

Paraplegia, spinal deformity, chronic pain

■ Treatment:

Depending on the patient's age, general condition, and disease progression, various treatments can be used.

Treatment with antituberculous drugs can be done by conservative or surgical treatment. Of course, nutritional improvement and stabilization to improve the general health condition should be done basically.

Conservative treatment is a gypsum bandage or an accessory fixture that allows external fixation of the lesion spine and walking alongside anti-tuberculosis therapy. It is a good adaptation to early patients with fewer pelvic and bone destruction.

In the past, larynxectomy, posterior lumbar fixation, lesion sole and drainage, and rib transversal resection were used in the past, but they are rarely used recently and sometimes used in combination with other surgical methods. Currently, the most common surgical methods are vertebral resection and anterior fusion, and spinal anterior and posterior fusion.

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