Tuberculous Spondylitis: Symptoms, Cause & Treatment

TB (Tuberculosis) is a highly infectious disease that mainly affects the lungs. It is the 13th leading cause of death worldwide; 1.5 million people died from this disease in 2020 as per WHO (World Health Organization). However, TB is normally curable and preventable under the right conditions.

When a tuberculous infection spreads to the spine, it is called tuberculous spondylitis. It is a rare but serious infection that is fatal without medical treatment. Bacterial damage to the spine can cause paralysis, abnormal back curvature and severe pain.

Although this condition is serious, it is treatable.  The treatment first addresses the infection. Additional treatments can include surgery to correct any damage to the backbone and spine, and attending to any underlying conditions that could be weakening your immune system. 

What is Spine Tuberculosis?

TB (tuberculous) spondylitis is also called Pott’s disease, spinal TB and TB of the spine. The same microorganisms that cause TB are responsible for this disorder.

It happens when the bacteria travel to the spine and then invade the backbone. Over time, the disease can cause the bones to collapse,  leading to a curve in the back and spinal abnormalities. 

What are the Symptoms of Spine Tuberculosis?

Initially, tuberculous spondylitis causes the symptoms usually associated with TB, including:

• Coughs that produce blood
• Unintentional weight loss
• Chills
• Night sweats
• Fever

It can cause many additional symptoms once the infection progresses to the spine. The full extent of symptoms can depend on – if the bacteria affect the nerves that run through the spinal cord and how far the bacteria spread.

The Additional Symptoms Associated with this Condition are:

• Sharp back curvature
• Abnormal spinal bending
• Limb paralysis
• Reduced control over limb movement, particularly in the legs
• Severe back pain

What are the Causes of Spine Tuberculosis?

The bacteria that causes TB (Mycobacterium tuberculosis) is the same one which causes tuberculous spondylitis as well. This bacterium spreads among people who’ve been exposed and is contagious. 

If your immune system is weakened from any medications or health conditions, such as tuberculous spondylitis, then you are more likely to experience severe complications of the bacteria. People with weakened immune systems are at higher risk in certain locations, such as:

• Developing countries (like India)
• Homeless shelters
• Correctional facilities

Also Read: 10 Tips to Prevent Spine Problems

How is Tuberculous Spondylitis Diagnosed?

A medical appointment is the first step in diagnosing tuberculous spondylitis. During your appointment, your doctor and you will discuss your medical history and symptoms. 

Your doctor will order a TB test if they suspect you have tuberculous spondylitis. This examination searches for TB bacterial infection.

TB Diagnostic Test has Two Versions, which are:

Blood Testing

Blood tests can look for TB. This test is more often done for people who are suspected of having active TB infections, but it is more expensive to do than a PPD test. 

PPD (Purified Protein Derivative) Test 

A PPD test is a two-step TB test. This test is done by injecting a protein under your skin that reacts to the TB bacteria and causes a visible bump at the injection site if TB is present.

Your doctor will likely perform further tests to search for indications of tuberculous spondylitis if TB is shown to be present. This usually includes imaging tests, like MRI and X-rays. 

These tests are done to look at your spine and check for abnormalities or degeneration. MRIs can also detect epidural abscesses (collections of bacteria in the spine)  that can happen with tuberculous spondylitis.

You may also have a biopsy in some cases. Your doctor may order a biopsy if there is a mass in your spine that could be caused by some conditions like spinal cancer or by tuberculous spondylitis. 

A biopsy will be used to determine whether there are TB bacteria in your spine as imaging can’t always detect the difference. A small sample of the mass will be removed during the biopsy.  After that, it will undergo TB testing in a lab.  

What is the Treatment of Spine Tuberculosis?

A treatment plan for tuberculous spondylitis usually has multiple parts. Treating the TB infection is always the first part. TB is treated for most people with a combination of medications taken over several months.

Additional steps will depend on the extent of spinal damage and any co-occurring conditions. This can include treatment for conditions that may be weakening your immune system, such as HIV. You can lessen your chance of developing further serious infections by starting treatment for these illnesses. 

Surgery might be needed to treat spinal damage. Surgical options can help correct decompression of the spinal cord and severe curvature. This can help reduce symptoms such as limb paralysis and pain and help relieve pressure on the nerves. 

Conclusion

Tuberculosis of the spine is a serious condition which can lead to death if not treated, so it is advisable to seek medical help from an experienced spine surgeon. Timely care and help can ensure you receive appropriate treatment for a successful cure. 

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures as well. In case you need to consult a spine surgeon, reach out to us, or book a direct appointment with Dr. Ashwani Maichand  at the CK Birla Hospital. 

FAQ’s

Is Tuberculosis of the Spine Curable?

If detected early and provided with proper medicinal compliance, spinal TB is curable. It might take up to 20 to 24 months of different antibiotics treatment along with therapy to get rid of spinal TB. 

Is TB of the Spine Serious?

It is a very dangerous type of skeletal TB as it can be associated with neurologic deficits due to significant spinal deformity and compression of adjacent neural structures. 

Can Bone TB Cause Death?

An untreated spinal TB can be fatal. Early detection is key for improved prognosis.