Spinal Condition
Spinal Tuberculosis (Pott's Disease) Treatment
TB of the Spine — Diagnosis & Surgical Management
Spinal tuberculosis (Pott's disease) — the most common form of musculoskeletal TB — accounts for up to 50% of all skeletal TB cases in India and requires early diagnosis to prevent irreversible neurological damage.
Understanding Spinal Tuberculosis
Mycobacterium tuberculosis reaches the spine haematogenously, typically affecting the anterior vertebral body. Progressive bone destruction leads to vertebral collapse, kyphotic deformity (gibbus), and paravertebral abscess formation. Cord compression from abscess, granulation tissue, or bony collapse produces Pott's paraplegia — the most feared complication. With early diagnosis and a full course of anti-tubercular therapy (ATT), most cases resolve without surgery. Surgical intervention is indicated for neurological deficit, progressive deformity, large abscess, or diagnostic uncertainty. Dr. Sparsh Jaiswal performs minimally invasive debridement and stabilisation, minimising blood loss while achieving radical clearance of diseased tissue.
infoCommon Causes
- Haematogenous spread of Mycobacterium tuberculosis to the vertebral body
- Close contact with active pulmonary TB
- Immunocompromised states — HIV, diabetes, malnutrition, steroid use
- Reactivation of latent TB during periods of immune suppression
symptomsKey Symptoms
- check_circleInsidious onset back pain — often worse at night
- check_circleConstitutional symptoms — low-grade fever, night sweats, weight loss, fatigue
- check_circleVisible spinal deformity (gibbus/angular kyphosis)
- check_circleParavertebral or psoas abscess causing swelling
- check_circleWeakness or paralysis of the lower limbs (Pott's paraplegia)
- check_circleBladder and bowel dysfunction in advanced disease
Diagnosis
MRI with contrast is the most sensitive investigation. CT-guided biopsy or open biopsy confirms microbiological diagnosis. ESR, CRP, Mantoux test, and IGRA support clinical diagnosis. Chest X-ray and CT chest assess pulmonary involvement.
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