- Tuberculosis of the spine - especially manifestations
- Diagnosis and treatment
Diagnosis of tuberculosis of the spine
Diagnosis of tuberculosis of the spine is quite complex, and often the disease is detected at later stages of development, when there were noticeable deformation and other problems with the spine. Symptoms of tuberculosis of the spine may be similar to the symptoms of these disorders, which the doctor must rule in the differential diagnosis:
- Tumors of the spinal cord;
- Infections caused by the bacteria Mycobacterium kansasii;
- Septic arthritis
Arthritis - a variety of forms and complications
- The swelling of the spinal cord;
- Miliary tuberculosis;
- Multiple myeloma.
The tuberculin skin test at the 84-95% of patients with tuberculosis of the spine gives a positive result. In many cases, there is significantly increased erythrocyte sedimentation rate (100 mm / h).
For the diagnosis of tuberculosis of the spine can also be used biopsy, X-ray, computed tomography (CT) and magnetic resonance imaging (MRI). With biopsy sampling carried out the bone for microbiological studies, and, if necessary, carried out drainage of paraspinal abscesses, which are sometimes formed in patients with tuberculosis of the spine. A biopsy to diagnose a violation in 50-83% of cases.
With CT, you can better understand the state of the vertebrae and intervertebral discs, and to identify tuberculosis lesions, so this diagnostic procedure for suspected tuberculosis of the spine recently used more often than X-rays. CT also allows you to identify tuberculosis of the spine in the early stages of development.
MRI is recommended for the diagnosis of osteomyelitis, and infections affecting the intervertebral space, in addition, this procedure is most effective for the evaluation of patients who have tuberculosis of the spine spread to soft tissue. MRI can also reveal a pinched nerve
Pinched nerve - what to do when severe pain?
Which is frequently observed in patients with tuberculosis of the spine.
Treatment of tuberculosis of the spine
Before the advent of anti-TB drugs Pott's disease treated with prolonged immobilization - it was prescribed bed rest and / or wearing a brace. While mortality from tuberculosis was around spine 20% and the relapse occurred in 30% of cases.
Despite the fact that the efficiency with Corsets spinal tuberculosis is controversial, they still often used to prevent skeletal deformities.
However, the most important part of treatment for this disorder today is drug therapy. In most cases, patients are assigned to receive these drugs - isoniazid, rifampicin, pyrazinamide, ethambutol and streptomycin. If tuberculosis
Tuberculosis - a full recovery is not guaranteed
spine caused by drug-resistant bacteria that can be assigned to other anti-TB drugs.
Specialists still no consensus regarding the optimal duration of treatment for tuberculosis of the spine. Although the results of several studies speak in favor of a course of therapy lasting from six to nine months, many doctors usually prescribe a course of treatment, which lasts from nine months to a year, and in some cases - even more. When choosing the length of treatment, doctors take into account the stage of the disease, the overall health of the patient, as well as how quickly after the start of medication he had TB symptoms disappear
Symptoms of TB - how to recognize the disease
Isoniazid - a powerful anti-TB drug, which is effective against bacillus Mycobacterium tuberculosis. He, like rifamycin, taking over the entire course of treatment. The most common side effects (occur in 10-20% of patients) are anorexia, nausea, vomiting, abdominal pain and weakness. In 1-10% of patients while taking this drug observed dizziness, drowsiness, slurred speech, and the gradual deterioration of liver tissue. Less than 1% of patients isoniazid causes anemia, thrombocytopenia, systemic lupus erythematosus, and convulsions.
Rifampicin is used in the treatment of spinal tuberculosis in combination with at least another anti-drug. It can cause side effects such as skin rashes, nausea, diarrhea, muscle cramps, pancreatitis, muscle weakness, swelling, headaches. Other anti-TB drugs usually cause similar side effects - usually they are mild or moderate, and tested a few weeks after the start of treatment, when the body gets used to the medication.
Contagious tuberculosis of the spine
Since the vast majority of cases of tuberculosis of the spine occurs in people with active TB of the lungs, they can spread the infection by airborne droplets, and the probability of infection by contact with such people is quite high. In rare cases, when the primary site of infection is in the spine, the probability of infection is much lower.