Tuberculous spondylitis (aka Pott's disease) is an affliction affecting the spine. The disease is more often diagnosed in childhood and adolescence. In adults, it is less common. Sex does not affect the frequency of manifestation of the disease. Without timely treatment, the forecasts for the patient are the most unfavorable.
What is tuberculous spondylitis?
The disease is caused by the stick of Koch . It provokes a destructive process in the vertebrae and their deformation. Also there is a displacement of internal organs, as a result they cease to function properly. Tuberculous spinal fusion passes through the following stages:
- Pre - consecutive - at this stage patients rarely seek medical help. The disease often occurs asymptomatically or there are signs of a general nature: fatigue, weakness and other symptoms of intoxication of the body.
- Spondylic - at this stage, the inflammatory process spreads beyond the affected vertebra. As a result, deformation of this site occurs, a spinous process appears. All this increases the risk of compression fracture of the spine. At this phase, tuberculous acute spondylitis occurs with pronounced symptoms. More often at this stage, they seek medical help.
- Post - emergency - at this phase, the intensity of the inflammatory process stops . Symptoms become less pronounced. The kyphosis is clearly defined. Because of the deformation and displacement of the vertebrae, the roots of the spinal cord can be compressed. In the future it causes paralysis.
Tuberculous spondylitis can be localized in such parts of the spine:
- cervical;
- thoracic;
- lumbosacral.
How is tuberculous spondylitis transmitted?
Infection occurs in several ways:
- Hematogenous - a stick of Koch extends through the body through the circulatory system.
- Contact - this way of infection occurs with tuberculosis of internal organs.
- Lymphogenous - the infection spreads to the organs and tissues through the lymph.
To understand if tuberculous spondylitis is contagious, you need to remember that in most cases, the disease occurs in patients with active lung disease. As a result, the disease can be transmitted to surrounding people by airborne droplets. However, if the patient has Pott's disease - the primary focus of infection, the probability of getting infected from it is small.
A greater chance of getting spondylitis in people with such pathologies:
- diabetes;
- oncological diseases;
- chronic diseases of internal organs;
- infectious diseases;
- after the transplantation of internal organs.
Tuberculous spondylitis - symptoms
At an acute stage of an illness such signs are shown:
- severe pain;
- impaired movement;
- elevated body temperature (37.5 ° C - 38 ° C);
- prostration.
If tuberculosis-spondylitis has affected the cervical region, the following symptoms are observed:
- frequent headaches;
- confusion of consciousness;
- dizziness;
- shaky gait.
To judge the tuberculosis of the thoracic spine can be on the following grounds:
- pain that increases with inspiration;
- numbness of the hands;
- tingling in the thoracic region.
Spondylitis of the lumbosacral spine is characterized by the following symptoms:
- problems with urination;
- numbness of the legs ;
- severe pain in the lower back.
There is a triad of signs of a neglected form of Pott's disease:
- Curvature of the spine (hump appears).
- Abscesses (on the thigh, in the popliteal fossa or on the chest appear fistulas).
- Symptoms of a neurological nature (sensitivity and motor activity of the legs and hands are impaired).
Tuberculous spondylitis - diagnosis
The doctor takes into account the features of the course of the disease, the patient's complaints about the presence of signs of intoxication and the limited mobility of the hands or feet. Identify a tuberculosis spondylitis blood test will help. He will indicate the inflammatory process in the body. With spondilitis, high rates of ESR. In addition to a general blood test, other diagnostic methods are used:
- proteinogram;
- analysis for immunoglobulins;
- biopsy;
- Analysis of urine;
- rheumatological tests.
The patient will be recommended to visit such specialists:
- therapist;
- rheumatologist;
- phthisiatrician;
- Traumatologist;
- neurologist.
Tuberculous spondylitis - X-ray signs
When this diagnosis is made, instrumental methods of examining the patient are used. They include:
- MRI;
- Ultrasound;
- radiography of the spine;
- CT.
If the doctor suspected a patient of tuberculous spondylitis, differential diagnosis will show the patient such pathology:
- vertebral engorgement;
- compression fractures;
- narrowing of intervertebral fissures;
- osteoporosis;
- deformation of vertebrae and end plates.
How to treat tuberculosis spondylitis?
The patient, who confirmed this diagnosis, should be hospitalized in a special medical institution of a sanatorium type. Tuberculosis spinal cord treatment involves an integrated. It is represented by the following activities:
- daily walks in the fresh air;
- proper nutrition;
- therapeutic gymnastics;
- using a supporting corset and a "gypsum bed";
- drug therapy;
- physiotherapy procedures.
The drug treatment of tuberculosis spondylitis has two directions:
- etiotropic - control of the pathogen;
- symptomatic - elimination of the clinical manifestation of the disease.
When etiotropic therapy prescribe such drugs:
- Isoniazid;
- Streptomycin;
- Rifampicin .
Symptomatic therapy involves the use of such groups of medicines:
- Corticosteroids (Prednisolone, Metipred).
- Vitamins of the rong group.
- Non-steroidal anti-inflammatory drugs (Meloxicam, Lornoxicam).
- Miorelaxants (Baclofen and Midokalm).
Tuberculous spondylitis - operation
Surgical intervention is performed only after the disease passes through the acute phase. To completely eliminate tuberculous spondylitis, treatment should be carried out in the first 6-12 months after the onset of the development of the disease. If the disease is started, the operation will not give the expected result. The same surgical intervention is aimed at eliminating physical defects. In this procedure, the broken vertebrae are replaced by metal prostheses.
Consequences of tuberculosis spondylitis
If you do not start treatment on time, you will have serious health problems. The most "harmless" consequence of this disease is a twisted posture. Complications of tuberculosis spondylitis can be more dangerous. Here are the most common of them:
- disturbances in the work of the genitourinary system;
- paralysis of hands or feet;
- tuberculous meningitis;
- epiem;
- pericarditis ;
- dysfunction of the large intestine;
- mediastinitis.