Spine TB Specialist in Delhi, Rohtak, Delhi NCR, Dwarka, Najafgarh, Palam, Janakpuri, Subhash Nagar, Paschim Vihar

Tuberculosis is one of the first infective disease known to mankind and it is caused by organism called Mycobacterium tuberculosis. Lungs are the most common organ to be infected by the Tuberculosis followed by bone and joints, making it most common extra-pulmonary site of TB infection. The spine is the most commonly afflicted skeletal region, followed by the hip and knee. Spinal tuberculosis accounts for almost 50% cases of skeletal tuberculosis.

Spinal tuberculosis is also known as Pott’s Spine. Spinal tuberculosis can occur in anyone at any age, however, it mostly effects Children and elderly. Prolonged exposure to infected people, immunodeficiency’s (HIV, alcohol and drug misuse), overcrowding, malnutrition, poverty and a lower socioeconomic status are all known risk factors for tuberculosis. Dr. Hamza Shaikh is a renowned spine TB specialist in Delhi. He offer best spine Tb treatment in Dwarka, Delhi, Najafgarh, Palam, Janakpuri, Subhash Nagar, Delhi NCR and Paschim Vihar.

Symptoms of Spinal Tuberculosis Infection

Spinal TB progresses slowly and insidiously. The entire length of the sickness ranges from a few months to a few years, with an average disease duration of 4 to 11 months. Patients typically seek medical counsel only when they are experiencing severe pain, deformity, or neurological concerns.

In uncomplicated disease

The patient typically presents with back pain which occurs more on rest and especially associated with night time severe pain/night cries and rarely, radicular pain can be the main presenting symptom. Constitutional symptoms including weight or appetite loss, fever, and malaise/ fatigue are less commonly associated with extrapulmonary tuberculosis than pulmonary disease.

In complicated disease

In complicated tubercular spine disease patient may present with deformity, instability, and neurological deficit due to spinal cord/nerve compression by the pus or deformity.

Pediatric Spinal TB

spine bones in children are soft and more flexible, they are prone to develop severe deformity progression. Such worsening of deformity in children can also occur even after the infection has completely healed, and follow-up is needed until skeletal maturity.

Investigations

Divided into Three Parts

Evaluating the infection in spine by X rays, MRI and/or CT scan of spine
Basic work up for the TB infection- CBC, LFT,KFT, ESR, CRP, Monteux test, sputum culture
Role of biopsy: Tissue diagnosis of the radiologically suspected TB infection before starting ATT drugs is now a recommended approach for spinal Tuberculosis management. Percutaneous fluoroscopic or CT-guided biopsy of spine bone lesions can safely provide tissue samples for the diagnosis and allow therapeutic drainage of large paraspinal abscesses as well.

Treatment

Non-Operative

Drug Therapy: In most of the uncomplicated cases of spinal tuberculosis, a course of anti-tubercular (ATT) drugs is the main-stay of the treatment. ATT includes four types of drugs: Isoniazid, Rifampicin, Ethambutol and Pyrazinamide as a first line of therapy. As per the WHO and Indian guidelines, a total of 6-12 months duration of ATT is required for complete healing of infection. In case of multi-drug resistant tubercular infection, in which first line ATT do not work, requires the course of second line of ATT, which are mostly in form of injections like levofloxacin, amikacin, capreomycin, kanamycin, streptomycin, ethionamide etc for a duration of at least 2 years.
Diet: Patient should eat diet rich in Vitamins A,C,E, Zinc and B-complex. TB patients often experience appetite loss, thus it is critical that they consume protein-rich meals such as eggs, paneer and soya chunks, as well as fish, chicken, and turkey. lean meat are excellent choices for non-vegetarians. These foods can be absorbed easily by the body and can provide the required energy to fight the infection.
Spinal Orthosis: It is a reasonable option used for pain control and prevention of deformity during the ATT course for an uncomplicated spinal tuberculosis.

Need of Surgery in Spinal Tuberculosis

When there is weakness in hands, legs or difficulty in balance while walking
When there is bone destruction to such an extend leading to spinal deformity with instability pain
When there is no response to medical therapy - Continuing progression of kyphosis or instability
Large paraspinal abscess
Percutaneous needle biopsy sample is inadequate to provide tissue diagnosis of TB.
In paediatric spine even after the healing of active infection, in view of risk of progressive deformity of spine as the child grows.

Case

Spine Tb Specialist in Delhi

In uncomplicated disease

In complicated disease

Pediatric Spinal TB

Divided into Three Parts

Non-Operative

Need of Surgery in Spinal Tuberculosis

Case-1

Case-2

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