Pott's disease is extrapulmonary spinal tuberculosis that affects it for various reasons. The lower thoracic and upper lumbar vertebrae affect the disease most often.
Men are most affected by this infectious disease . But it is diagnosed in many segments of the population. Tuberculous spondylitis develops very slowly, so it is quite difficult to detect pathology at an early stage.
Etiology and origin of spondylitis
Bacteria reach the site of infection through the bloodstream. The focus of the inflammatory process begins in the cancellous bone. In 5% of cases, spondylitis is found on the posterior surfaces of the vertebral bodies.
As the disease develops, spinal tuberculosis gradually increases and spreads. Two or more adjacent bone elements are involved in the inflammatory process, with expansion under the anterior longitudinal ligament or directly through the intervertebral disc. Sometimes several of them may be involved, while healthy tissues separate them.
How does spinal tuberculosis progress? Bone elements lose their mechanical strength due to increasing destruction under the influence of body weight. Excessive weakening of the links leads to angular deformation.
The severity of the distortion depends on the degree of destruction, the level of damage and the number of bone bodies involved in the pathological process.
Clinical manifestations of spondylitis
The initial signs are vague and often indicate not only tuberculosis of the spine. Symptoms may be similar to those for other pathologies that occur simultaneously in the body. These are manifestations such as:
- general malaise;
- fatigue;
- loss of appetite and weight;
- in children - loss of desire to play in the fresh air;
- fever is possible after lunch or evening.
Local signs are pain, spasm and soreness. They are less pronounced than with other diseases. Acute pain, as a rule, can characterize not only tuberculosis of the bones of the spine. Symptoms of the disease can be different: sometimes patients complain of stiffness.
Despite the large number of people suffering from the disease in the early stages, clinical signs may not appear. Many symptoms are absent even in the acute course of the disease.
External signs of tuberculous spondylitis
A man’s gait changes almost immediately. The steps become short, it is difficult for the patient to move around.
Compression of the nerve roots leads to damage to the nervous system. It manifests itself:
- hyperactivity of tendon reflexes;
- muscle weakness;
- spastic gait.
At later stages, tuberculosis of the spine in adults can be accompanied by a deterioration of tendon reflexes in the following sequence:
- gait becomes awkward;
- there is weakness in the limbs, you have to walk with support;
- muscles atrophy, the patient is unable to get out of bed, cannot move.
The causes of the disease
Bacterial infections of the spine are the most common type of pathology. They are caused by various microorganisms. The list of such diseases includes such ailments as:
- spondylitis;
- discite;
- spondylodiscitis;
- epidural abscess.
Often harmful to humans, microorganisms pass through the bloodstream in the vertebrae, which provokes spinal tuberculosis. Causes of the disease:
- physical injuries;
- adverse working conditions;
- infectious diseases.
The main cause of the pathology is direct contact with an already infected person.
Major risk groups
The penetration of microorganisms into the lungs of a healthy person provokes the development of infection not only in the lungs, but also in the bone structures of the body.
Patient groups at risk:
- smoking individuals;
- undernourished;
- patients with AIDS or other similar diseases that cause an immune system disorder;
- patients with diabetes;
- those who abuse drugs.
Infection can occur even after surgery.
Classification of the disease and stages of development
There are two types of manifestations of the disease and five stages of development. Spinal tuberculosis is bone and synovial. Hearing such a diagnosis is very scary. It affects bone cartilage, destroys and destroys them, causing pathologies such as arthritis and arthrosis, exacerbating the course of the disease.
Stages of development of spinal tuberculosis:
- Initially, a healthy person is infected.
- At stage 2, bacteria multiply very quickly, destroying healthy cells.
- Further, the appearance of the first symptoms is characteristic.
- At stage 4, the multiplication of microorganisms reaches its peak, the spine is affected.
- The last stage is a repeated cycle in which a person himself becomes a peddler of infection.
The development of the disease has three successive stages:
- Primary osteitis.
- Arthritic phase.
- Post-arthritic phase.
If you do not start timely treatment, then the disease can significantly drag on, which will lead not only to disability, but also to the death of the patient.
Diagnosis of spondylitis
The diagnosis of tuberculosis can be made by clinical and radiological examination.
Then the patient undergoes a differential diagnosis, including collecting an anamnesis, clarifying symptoms. Congenital defects of the spine:
- Calvet's disease (in young patients).
- Schmorl's hernia and Scheuermann-Mau disease (can sometimes occur in adolescents).
With tuberculosis on an X-ray examination, the fields of the vertebrae are fuzzy, the disk space is reduced.
To identify pathology, it is necessary to conduct laboratory tests:
- take a blood test;
- make ESR and CRP;
- examine the liver and kidneys;
- conduct a biopsy by borrowing tissue fragments for microbiological examination and accurate diagnosis of pathology.
Modern treatments
Before antibiotics, a large number of people died with a diagnosis of "spinal tuberculosis." The treatment today has reached such heights that people can live with this ailment for many years, maintaining a normal state and regularly undergoing examination. Thanks to the introduction of resuscitation blocks, the use of spinal devices, the cure of the disease became possible.
Chemotherapy is a treatment for tuberculous spondylitis. The presence of a neurological deficit complicates the healing process.
If the disease is diagnosed and treated at the earliest stages, before bone destruction and deformation occur, the patient usually fully recovers.
Modern methods of treatment are divided into 2 types:
- conservative therapy;
- surgical intervention.
Both species, of course, bring a positive effect. But conservative therapy does not always have the proper effect on the pathological process. The surgical treatment has a better effect on a person diagnosed with spinal tuberculosis. The operation is carried out by qualified doctors, then the patient is under the supervision of hospital staff for some time.
Conservative Therapies
The treatment of patients with neural deficiency boils down to anti-tuberculosis chemotherapy. It is carried out using drugs such as Isoniazid, Rifampicin, Pyrazinamide and Ethambutol. All of them are used as the first line of drugs that directly affect spinal tuberculosis. Symptoms of the manifestation of the disease will gradually go away if the treatment is carried out correctly. Depending on the course of the disease and the manifestation of symptoms, the drugs can be replaced or added. Dosage is regulated depending on the condition of the patient, his age and weight.
Treatment with anti-TB drugs during bed rest gives long-term results and eliminates repeated relapse.
Patients with advanced stages require a more serious approach. The main thing in the treatment is chemotherapy and bed rest. Patients are placed in a clinic under the constant supervision of doctors and nurses. Conservative therapy does not always give a positive result. In some cases, surgical intervention is necessary.
An operational approach to curing the disease
Surgery is necessary for decompression of nerve structures and drainage of abscesses. As a rule, for children, such procedures are performed to correct deformities associated with growth.
It is impossible to cure the disease on your own, since complete rest and complex treatment are required. When conservative therapy did not cure spinal tuberculosis, the symptoms in adults begin to worsen and the need for surgery appears.
The surgeon has the task of removing the vertebra that was affected by the disease. A transplant is placed in its place. The tissue needed for transplantation is taken from the fibula from the patient. This is to ensure that the risk of rejection is minimized and there is a greater chance that the operation will help.
It must be remembered that the consequences of the disease can be irreversible, and surgical operations can affect spinal tuberculosis. Photos of patients with this infectious disease clearly provide vivid examples of the formation of pathology and its consequences.
The data obtained through x-ray and MRI, enable surgeons to predict the outcome and determine the volume of the operation, as well as reduce the risk of complications after it.
It takes about 4 years to fully recover. That is, even surgical intervention does not guarantee a quick recovery of the body. Many fatal cases have been recorded.
What is the probability of contracting spondylitis?
Is spinal tuberculosis contagious or not? Many people are puzzled by this question. But the exact answer to it does not exist. Highly qualified doctors have been working on this problem for years.
Of course, you must beware of people with this diagnosis or take all precautions if the sick person is your relative or acquaintance.
The selection of harmful microorganisms occurs only in the case of:
- if the patient has an open form of tuberculosis;
- a healthy person was in contact with the patient, not observing the precautionary rules;
- ingestion of food from one dish increases the risk of infection through the digestive tract.
Infection with spondylitis is possible in utero: if the mother is sick, infection occurs through the placenta. The likelihood of acquiring the disease is high in direct contact with a sick person.
Precautions and Prevention
In tuberculous disease of the spine, prevention is of great importance. Its methods are necessary to eliminate the risk of a subsequent occurrence of the disease. It is very important to relax on time, to avoid excessive loads on the body as a whole.
Also try:
- do not undergo hypothermia;
- increase immunity;
- eat well and eat well;
- avoid injuries.
The main preventive measure is timely vaccination against tuberculosis. Injection is required. It is necessary to protect the body from a dangerous infectious disease. They begin to do it even in infancy, and the procedure is carried out in the first days of the child's life.
There is also a risk of spondylitis in the workplace. Medical personnel working in this area have the highest risk of infection. They need to be examined regularly and take anti-TB drugs as a preventive measure.