Tuberculosis of Spine
Spinal tuberculosis is the commonest form of bony tuberculosis constituting about 50% of all the cases of tuberculosis of bones and joints. Though previously confined mainly to developing world, rapid spread of AIDS throughout the world has led to rapid surge of tuberculous infection even in developed world also. Patient usually present with stiff and painful movements of spine with localized prominence of spine bones which is painful on deep pressure .In addition during active phase of the disease patient may have low grade temperature in the evening, rapid loss of weight, night sweats and loss of appetite. In advanced stage patient may present with paralysis, the dreaded complication of spinal tuberculosis .Tuberculosis of spine bones, in some children, in spite of adequate treatment with anti-tuberculosis drugs may lead to grotesque, progressive, ugly looking deformity of back because of damage to growth centers of spine during active phase of the disease. Such patients may present with late onset paralysis in the adult or adolescence due to stretching of spinal cord over the bent bones. Progressive paralysis in spite of adequate medical treatment or high risk signs on x-rays in children may require surgical cleaning of infected bone, removal of pressure from spinal cord, straightening of bend in spine bones by fixation with rods and screws so that patient can be mobilized as soon as possible after surgery.
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