- Spinal TB can be a debilitating condition
- Timely diagnosis and treatment is important
- TB is curable when detected on time
World Tuberculosis Day is observed on March 24 across the world. The day is meant to raise awareness about tuberculosis and how early detection can help in curing the disease effectively. Generally perceived as a pulmonary disease, tuberculosis or TB can also affect other organs and body tissues including the thoracic part of the spine. Known as Spinal TB, it is a potentially serious infectious condition also known as 'Pott's' disease. People with spinal TB experience constant and unbearable back pain since the virus degrades the discs that cushion the vertebrae. It is the most common form of extra pulmonary TB accounting for 1% to 2% of all cases and is regarded as one of the oldest maladies known to mankind1.
World TB Day: Understanding spinal TB and its symptoms
Spinal TB occurs when the germ mycobacterium tuberculosis gets lodged within the vertebral body. While the organism initially causes an inflammatory reaction, with time, it can lead to destruction of the bone and supporting structures. A person with spinal TB experiences back pain and painful movements in the early stages apart from fever and loss of appetite and weight. When it progresses further, the vertebrae can collapse and become fractured with formation of pus within and adjacent to the spinal column - in extreme cases, it can lead to paralysis of hands or legs and the person may develop a hunch back. There is a need to raise awareness on the severity of the condition and timely detection. It is also important to understand that TB is curable when detected on time and provided the medication schedule is followed correctly.
Spinal TB: Diagnosis and management
An MRI scan can pick up the infection, but a definitive diagnosis is done using pathological / microbiological examination of the disease tissue obtained from the wound site. Treatment and management of this condition is done to relieve pain, prevent deformity of the spine and restore its alignment and avoid further complications. Antibiotics are usually prescribed as the mainstay for spinal TB. Patients must remember to adhere to the medication schedule to be able to get cured completely. Skipping therapy or medication can make the disease worse and lead to drug resistance as well in some cases. Surgery is needed only in about 20% of the cases.
There are several minimally invasive treatment procedures available today for the treatment of spinal TB and they are safe as well. Some of these include CT guided drainage of paravertebral abscess or clearing of the dead and diseased tissue through either conventional techniques or endoscopic methods. Patients who develop paralysis may need surgery to remove pressure on the spinal cord.
World TB day: Prevention tips for TB
TB usually affects those with a lowered immunity and therefore, the first goal of prevention should be to improve resistance. Some tips to do this are as follows.
1. Make sure to consume fruits and vegetables since they are high on antioxidants - especially those that are dark or brightly coloured. Include a lot of protein in your diet and avoid processed food. It is also important to drink adequate quantity of water to flush out toxins from the body.
2. Ensure you follow basic hygiene practices including covering the mouth, washing hands after visiting a public place, etc.
3. Get vaccinated with the BCG (Bacille Calmette-Guerin), which is a live vaccine against TB. Also undertake regular screening for vital health parameters.
4. Maintain good ventilation and cleanliness at home. TB bacteria can remain suspended in the air in the absence of proper ventilation for several hours and natural light can kill them.
Spinal TB can be a debilitating condition and therefore, it is important to raise awareness around prevention. Those who are affected must get timely diagnosis and adhere to the doctor's advice for better outcomes.
(Dr Vishal Sehgal, Medical Director, Portea Medical)
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