Tuberculosis of the Spine- Pott’s Spine Role of Conservative and Operative

Tuberculosis is a potentially profound disease that mainly affects lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via cough and sneezes.

Tuberculosis of the spine which is also widely known as Pott’s disease is a form of tuberculosis that occurs outside the lungs whereby the disease is seen in the vertebrae. Tuberculosis can affect several tissues outside the lungs including the spine, a kind of tuberculosis arthritis of the intervertebral joints.

Latent TB. In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn’t contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB.

Active TB. This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later.

Signs and symptoms of active TB include:

  • Coughing that lasts three or more weeks
  • Coughing up blood
  • Chest pain, or pain with breathing or coughing
  • Unintentional weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, signs, and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

According to the diagnosis, the patient should see the doctor if he/she has a fever, unexplained weight loss, drenching night sweats or a persistent cough. These are the usual signs of TB, but they can also result from other medical problems.

The Centers for Disease Control and Prevention recommends that people who have an increased risk of tuberculosis be screened for latent TB infection. This recommendation includes:

  • People with HIV/AIDS
  • IV drug users
  • Those in contact with infected individuals
  • Health care workers who treat people with a high risk of TB

Anyone can be a victim of tuberculosis, but certain factors can increase your risk of the disease. These factors include:

Weakened immune system

A healthy immune system often efficiently fights TB bacteria, but your body can’t mount an effective defense if your resistance is weak. A number of diseases and medications can weaken your immune system, including:

  • HIV/AIDS
  • Diabetes
  • Severe kidney disease
  • Certain cancers
  • Cancer treatment, such as chemotherapy
  • Drugs to prevent rejection of transplanted organs
  • Some drugs used to treat rheumatoid arthritis, Crohn’s disease and psoriasis
  • Malnutrition
  • Very young or advanced age

Without treatment, tuberculosis can be fatal. If its not treated in time, it may affect your lungs, but it can spread to other parts of your body through your bloodstream. Examples of tuberculosis complications include:

  • Spinal pain. Back pain and stiffness are common complications of tuberculosis.
  • Joint damage. Tuberculosis arthritis usually affects the hips and knees.
  • Swelling of the membranes that cover your brain (meningitis). This can cause a lasting or an intermittent headache that occurs for weeks. Mental changes also are possible.
  • Liver or kidney problems. Your liver and kidneys help filter waste and impurities from your bloodstream. These functions become impaired if the liver or kidneys are affected by tuberculosis.
  • Heart disorders. Rarely, tuberculosis can infect the tissues that surround your heart, causing inflammation and fluid collections that may interfere with your heart’s ability to pump effectively. This condition, called cardiac tapenade, can be fatal.

Prevention

If you test positive for latent TB infection, your doctor may advise you to take medications to reduce your risk of developing active tuberculosis. The only type of tuberculosis that is contagious is the active variety, when it affects the lungs. So if you can prevent your latent tuberculosis from becoming active, you won’t transmit tuberculosis to anyone else.

  • Protect your family and friends: If you have active TB, keep your germs to yourself. It usually takes a few weeks of treatment with TB medications before you’re not contagious anymore. Follow these tips to help keep your friends and family away from getting sick:
  • Stay home. Don’t go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.
  • Ventilate the room. Tuberculosis germs spread more often in small closed spaces where air doesn’t move. If it’s not too cold outdoors, open the windows and use a fan to blow indoor air outside.
  • Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
  • Wear a mask. Wearing a surgical mask when you’re around other people during the first three weeks of treatment may help lessen the risk of transmission.

The treatment course for each patient depends on various factors such as patient’s age, the severity of the back pain and response to other treatments. With proper medications, the patient is prescribed full bed rest to take vitamin supplements and restrict much of physical labour. For quick recovery, patients are advised to do spinal exercises and sometimes, a back brace is necessary. If the damage becomes severe, the doctors advise a surgery. Back surgery is the last resort and usually, patients do not require it.