Spinal Tuberculosis

Spinal TB results from circulatory disturbance and tuberculous infection causing vertebral lesions. Affected vertebrae show bony destruction, necrosis, caseation, and abscesses; collapse produces spinal curvature with prominent spinous processes and kyphos, especially in thoracic TB. Spinal TB is about half of osteoarticular TB, most often in children and adolescents. All vertebrae may be involved: lumbar most common, then thoracic, thoracolumbar third, and cervical/sacral rare. Vertebral body TB is ~99%, posterior arch ~1%. Patients have fatigue, anorexia, afternoon low fever, night sweats, and weight loss; occasional acute deterioration with remittent fever ~39°C is often misdiagnosed as severe cold or acute infection.

Common Symptoms

Spinal and limb deformities; kyphosis; weakness; abnormal posture; vertebral TB; anorexia; night sweats; low fever; weight loss; lumbar spinal pain

Causes and Pathogenesis

Spinal TB is secondary, arising from pulmonary, digestive, or lymph node TB, hematogenously seeding bones and joints.

Treatment

Surgical treatment, supportive therapy, rehabilitation

Preventive Measures

1. Actively control infections elsewhere. 2. BCG vaccination clearly prevents hematogenous disseminated (miliary) TB and tuberculous meningitis in infants and children with immature cellular immunity. 3. Contact prevention: Pulmonary TB patients should adhere to full therapy; after 2 weeks of standard treatment infectiousness drops 95%. Contacts should be screened. Disinfect: boil utensils/clothes for 10-15 min, sun bedding 4-6 h, or UV-disinfect for 2 h. Ventilate every 10 minutes (4-5 exchanges remove 99% of airborne bacilli). Practice separate meals, personal toiletries, and handwashing. 4. Drug prophylaxis: Strongly positive Mantoux reactors, open-TB contacts, silicosis, dialysis, diabetes, or long-term corticosteroid users may take isoniazid (adults 1 mg/kg, children 10 mg/kg) for 1 year. The goal is to prevent disease in those already infected; only ~10% of infected persons ever develop TB, depending on bacillary virulence and host resistance.

Department to Visit

It is recommended to visit the Orthopedic Surgery department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.