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Spinal tuberculosis, also known as extrapulmonary or Pott’s disease, is a rare form of tuberculosis that damages spinal discs and causes deformity. It has been a problem for thousands of years and is more common in developing countries and AIDS populations. Treatment includes anti-tuberculosis drugs and surgery in severe cases.
Spinal tuberculosis is a rare form of tuberculosis in which the bacteria Mycobacterium tuberculosis colonize the spine, causing damage to the spinal discs and resulting in deformity. Archaeological evidence suggests that this disease has been a problem in human populations for thousands of years; it has been documented in a number of ancient human populations, including Egyptian mummies. It was identified and described in the 1800s, and a number of treatments are available for people with spinal tuberculosis.
Also known as extrapulmonary tuberculosis, a reference to the fact that tuberculosis usually involves the lungs, or Pott’s disease, named after the doctor who researched it in the 1800s, this condition can occur when tuberculosis bacteria spread through the system vascular to the spine. As the bacteria grow, they erode the discs between the vertebrae, causing the vertebrae to collapse. This puts pressure on the spine, leading to a curved deformity and instability. When multiple vertebrae are involved, the curvature can be severe.
People with spinal tuberculosis experience back pain and may develop loss of appetite and unexplained weight loss, along with fever due to active infection. Some patients develop neurological problems such as difficulty walking or paralysis in response to spinal damage. A medical exam should reveal a deformity in the back, and the spine can be further analyzed with the use of medical imaging studies to look for structural deformities and telltale signs of damaged spinal discs.
Treatment for spinal tuberculosis begins with anti-tuberculosis drugs, which may need to be taken for six months or more. If severe deformity is present, surgery to decompress the spine may be required to prevent spinal cord injury. Surgery is usually required in less than 10% of cases, especially if patients are treated early. Patients who are unsure about the need for surgery can meet with a surgeon to discuss options.
Spinal tuberculosis tends to be more common in developing countries, where people may not have access to tuberculosis treatment or cannot afford to complete rounds of tuberculosis treatment. It is also a potential complication of acquired immune deficiency syndrome (AIDS) and can be seen in AIDS populations worldwide, along with tuberculosis of the lungs. People with AIDS are more prone to developing a wide variety of infections due to reduced immune function, and their lack of immunity can make them vulnerable to rare complications such as spinal tuberculosis.
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