Spinal Tuberculosis ( TB ) of the spine is also known as Pott's disease, the tuberculosis that occurs outside the lungs, where it affects the spine. This disease generally infects the spine in the thoracic area (lower back chest) and the upper lumbar spine (upper back).
Causes of Spinal Tuberculosis
Tuberculosis is caused by a bacterium called mycobacterium tuberculosis . These bacteria spread through saliva sprinkling tubers or sneezing tuberculosis. The longer or more often a person interacts with the TB patient, the greater the risk of contracting the disease. Spinal TB occurs as a result of the spread of tuberculosis bacteria from the lungs to the spine to the spine / joints between the vertebrae. This condition causes the death of joint tissue and triggers damage to the spine. Some other risk factors that cause a person infected with spinal tuberculosis, among others:
- Low or poor socioeconomic factors also influence the quality of life standards, such as those living in slum and crowded areas.
- Living in areas with high or endemic tuberculosis cases.
- People who lack nutrients.
- People of the elderly group.
- HIV infected with low immune system.
- People with other declining immune systems, such as those with cancer, advanced kidney disease, and diabetes.
- Alcoholics or drug users.
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Symptoms of Backbone Tuberculosis
Like tuberculosis, the presence of spinal tuberculosis is difficult to detect. In general, the patient has chronic back pain with no known cause. Therefore, doctors have difficulty to diagnose. This kind of condition can last about four months.
In addition to the common symptoms of tuberculosis, spine TB also has additional symptoms that may be felt by some patients, among others:
- Attacks or symptoms that appear gradually.
- Sweating at night.
- Losing weight.
- Anorexia (eating disorder) that triggers weight loss.
- Back pain is localized.
- Has an upright and stiff body position.
- The curved spine causes the back to become bent (kyphosis).
- Swelling of the spine.
- Appears a lump on the groin that resembles a hernia.
- If it concerns the nervous system, there may be a nerve disorder affecting the organs of the body.
The diagnosis of spinal TB in children requires a high index of suspicion.
Diagnosis of Spinal Tuberculosis
The examination will begin with anamnesa about the symptoms experienced, the history of the disease and the history of family illness. Then will be done physical examination in the form:
- Examination of spinal arrangement
- A detailed examination of nerve function
- Evaluate the presence or absence of subcutaneous lumps in the stomach area
- Skin examination is included in hollow areas.
Then there will be a laboratory test to confirm the diagnosis. Some possible laboratory tests to obtain a diagnosis of spinal tuberculosis are:
- A red blood cell sedimentation test is performed to detect inflammation in the body.
- Mantoux skin test, performed to ascertain and determine whether the patient is infected with TB bacteria or not, based on skin reactions that have been injected tuberculin PPD.
- MRI and CT scan, was performed to determine the degree of suppression and bone element changes in the early stages of the disease. However, MRI is recommended over CT scans.
- X-ray of the spine and chest (CXR). This test is done to detect if there is damage or narrowing of space between spinal chips. In addition, this procedure can tell if there is tuberculosis in the respiratory tract that spreads to the spine.
- Biopsy of bone or synovial tissue by needle may be done to detect bacteria that cause spinal tuberculosis. The possibility of bacterial culture is needed to confirm the diagnosis.
Careful and thorough examination is important in order to differentiate the diagnosis of spinal TB from other conditions that have similar symptoms, such as:
- Spinal tumor
- Multiple myeloma
- Other cancer metastases.
Treatment of Backbone Tuberculosis
Slightly different from the condition of tuberculosis, spinal TB treatment is likely to require surgery as a form of additional treatment in addition to the antibitiotics given to treat tuberculosis. Spinal TB patients may also be advised not to move their spine until a certain period. This is done by wearing a bobat or special tool for a long time. In addition, a series of physical therapies will be advised to be followed in order to reduce pain as well as train the strength and flexibility of the bones.
In the treatment of spinal tuberculosis, antibiotics continue until the prescribed treatment period and should be spent. Some commonly used antibiotics include rifampicin and ethambutol. Side effects that may arise from these drugs, among others jaundice, fever, rash, itching, decreased appetite, and dark urine. Pain relief medication may be prescribed by a doctor as well. Spinal TB treatment therapy can last up to more than six months, depending on the severity and physical condition of the patient.
Although the healing period may last for months and years, the TB of the spine can be cured as long as it can be detected and treated properly. Another goal of this rapid treatment is to reduce the risk of patients affected by complications, such as various types of abnormalities or defects in the spine to experience paralysis.
Prevention of Spinal Tuberculosis
As with the treatment of tuberculosis, vaccination is a major preventive measure of spinal TB. The vaccine received is Bacillus Calmette-Guerrin or BCG vaccine. This vaccine must be given before the baby is three months old. Children, adolescents, and adults who have not received the BCG vaccine are also advised to receive the vaccine as soon as it will affect the decrease in effectiveness. Some other important spinal TB prevention measures are:
- Cover your mouth or wear a mask when in public when sneezing, coughing, or laughing.
- For non patient, wear mask if interacting with tuberculosis patient. Avoid too often interacting with the sufferers.
- Begin the habit of washing hands regularly.
- Make sure the house has good air circulation for the sake of air change in the house.