Spinal Tuberculosis (TB)/Potts spine.
TB is generally perceived in general population as a lung disease. However this disease also affects other parts of the body such as abdomen, bones especially spine, Brain and even skin. 5-10% of the total TB patients in India suffer from Bone TB. Spinal TB is generally ignored and diagnosed late due to lack of awareness.
The most common and early symptom of spine TB is back pain. It is generally ignored by patients thinking of normal back pain due to spondylosis/ arthritic pain. But most patients of arthritic pain get relieved in night on rest, whereas those due to TB, pain gets increased in night on rest. Patients with TB in their bones might or might not exhibit general symptoms of tuberculosis such as fever, fatigue, night sweats, lack of appetite and unexplained weight loss. Although about half of all patients with bone TB also have infected lungs, the disease is usually not active in lungs. Most patients with bone TB do not suffer from coughing and probably do not suspect that they have tuberculosis. At times, it may take months to year for initial symptoms to show.
Diagnosis is usually missed on plain Xrays. TB can be picked early only by MRI of the affected spine, with due suspicion in mind. Also, patients with bone TB are generally not contagious to family members living together or other people because the disease spreads through coughed-up active virus particles, unless you come in contact with a patient’s pus. Unlike TB of lungs, bone and spine TB takes a longer time of tretment depending on the severity of infection.
If left untreated, can spread from one vertebra to the next, weakening the bones and destroying the cushioning discs between the discs. In severe cases, the spine can collapse and compress the spinal cord, causing paralysis and numbness of the lower body.
Spinal TB is 100% curable
The treatment for normal bone TB may last at least 18 months to rarely 2 years. In case of spine TB causing paralysis, treatment and recovery time depends on if paralysis is mild, moderate or severe. Spine surgery ( SPINAL DECOMPRESSION+- FIXATION) may be required in case of worsening paralysis of the limbs.
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Most important is that the treatment should be continued till the completion of the course. In case of side effects of the TB medications, you have to immediately inform to your spine doctor, without stopping medicines yourself, Doctor will change to alternative medicine protocol. there should be no default in the treatment.