Spinal tuberculosis

Mechanism and manifestations

Also called Pott disease, it may progress gradually with pain and subtle general symptoms. Kyphosis or weakness may develop; exposure history and epidemiological context guide assessment.

Diagnosis and management

Imaging and microbiological or histological sampling support diagnosis. Treatment uses medically prescribed and monitored antituberculous drugs; surgery is considered for selected compression, instability or complications. Symptom-only care must not delay assessment.

Points to consider

Infection and inflammatory disease require different treatments. Fever, immunosuppression, infection history, unusual pain and neurological deficits influence urgency. Absence of fever does not exclude infection. Physical modalities must not delay necessary medical investigation.

Role of TAGMED care

With acute symptoms, urgent hospital assessment takes priority. This condition first requires medical diagnosis and, depending on the situation, specialist management. TAGMED services do not replace treatment of infection or tumor, stabilization of an unstable injury, or neurological or vascular treatment. Any conservative support should be considered only after diagnosis, restrictions and the treating team’s recommendations have been clarified.

Related concepts and distinctions

These concepts belong to the same field, but are not synonyms.

• Vertebral osteomyelitis — Infection of vertebral bone, often associated in adults with adjacent disc and endplate involvement.
• Septic facet joint arthritis — Infection of a vertebral facet joint that may spread into paraspinal tissues or the epidural space.
• Cervical involvement in rheumatoid arthritis — Inflammatory cervical joint and ligament involvement in rheumatoid arthritis, potentially causing atlantoaxial instability among other changes.

Medical references

1. Infectious Diseases Society of America. Native Vertebral Osteomyelitis in Adults: Clinical Practice Guidelines.
2. American College of Radiology / RSNA, RadiologyInfo. Spine MRI.

References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.