The symptoms and treatment of Pott disease (tuberculous spondylitis)

Inflammatory lesions of the spine tuberculous spondylitis

Tuberculous spondylitis is an inflammatory lesion of spine tuberculous process.

Most often this disease affects children, but it also can occur in adults. Typically, this form of the disease affects the thoracic spine.

If time does not begin treatment, the disease can lead to serious complications, such as deformity of the spine.

History

Tuberculous spondylitis is also called Pott’s disease.

In 1779, the English surgeon Percival Pott first described the clinical picture of this disease, it was later named after this doctor.

It turns out that the tuberculosis of the spine accompanied mankind since ancient times. In the study of the remains of ancient mummies found in Egypt, scientists have found signs of this disease.

With the development of modern medicine and the advent of anti-tuberculosis drugs, the number of patients in developed countries declined sharply.

But the disease is still common in developing countries where there are very good conditions for life.

The main reasons

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Usually, spondylitis is a secondary infection, that is, it begins to develop in patients with pulmonary tuberculosis. Pathogens hematogenous route into the spine and form there the source of the infection.

Will develop a secondary infection or not, primarily depends on the state of the human immune system. Usually this form of the disease most often affects men than women.

How is the disease?

The clinical picture depends on the phase of the process.

The phase of the first

For example, preponderancy phase is a General symptoms of TB regardless of its localization. The patient feels General weakness, fatigue, night sweats appearing.

Possible slight pain in one of the departments of the spine. To diagnose the diseases in this phase is very difficult, as no pronounced symptoms patients usually rarely go to the doctor.

Spondileza phase

The second phase is called spondilitis at this stage of the disease the tuberculous process usually extends beyond a single vertebra.

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As a result of its gradual destruction deformation occurs. Because of the compression of bodies of one or two vertebrae spinous process appears.

On examination, the patient it easy to spot, it sticks out the back and well contoured. The result of the formation of this process increase the risks of compression fractures of the spine.

In the future this kind of deformity in children leads to the formation of hump.

Postmodernistskaya phase

Postmodernistskaya third phase does not manifest itself pronounced symptoms, as the activity of the infectious process subsides, the patient does not feel any symptoms of the disease.

But in this phase clearly defines scoliosis or kyphosis. If the disease is left untreated, there is a further fracture may be formed hump, muscle paralysis, which occurs due to compression of the spinal cord, and also appear sinter abscesses.

Characteristic symptoms

Tuberculous spondylitis has specific symptoms, including back pain.

It is permanent, does not disappear after rest, massage and other means for pain relief.

If there is a pinched nerve roots, the pain may radiate to the limbs, chest and abdomen – it depends on the localization of the tuberculous process. Usually the pain increases with sneezing and coughing.

If a patient with secondary tuberculosis of the spine, in addition to back pain, it will have the following symptoms: fever, loss of appetite, weight loss, General weakness, cough and chest pain.

Almost all patients have varying degrees of deformity of the spine.

With the defeat of tuberculous infection of the cervical spine, you may experience stiffness of the neck, voice changes, the patient can swallow normally.

As a rule the disease develops gradually, but if you hit the upper part of the cervical, then the disease in this case progresses quickly.

Signs of illness in children

In children the disease is usually manifested by the following symptoms: loss of appetite, General intoxication, malaise, weight loss, irritability and sweating.

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If the child stopped to play with peers, become less mobile, hard time sleeping and often cries out, you must see a doctor.

How to diagnose the disease?

Diagnosis of this disease difficult, especially in adults.

The fact that tuberculous spondylitis is usually considered a disease of childhood.

In adult patients missing a hump, and the symptoms can be confused with other diseases.

That is why pathology is detected in later stages when there is already a noticeable deformity of the spine.

For the diagnosis of disease using the following methods:

  • biopsy;
  • radiography;
  • magnetic resonance imaging;
  • CT.

Is taken as the tuberculin skin test, which is almost 90% of patients give a positive result. On the basis of all the above studies usually the diagnosis is made and treatment.

Difficulties arise in the diagnosis of posterior spondylitis. In this case, primarily the pedicles of the vertebrae.

Usually, doctors diagnose the tumor and only after surgery and histological study establishes the exact diagnosis.

Methods of treatment

Before the advent of effective anti-TB drugs, the disease was treated with plaster corsets and bed rest.

The mortality rate reached about 20%. Despite the fact that the effectiveness of corsets have been many doctors questioned, they can still be used to prevent further spinal deformity.

The most effective method of treatment of tuberculous spondylitis of the spine is receiving antitubercular drugs. They need to take for a long time from six months to a year, at the discretion of the attending physician.

But if the disease caused by drug-resistant bacteria that can be prescribed other medications.

During treatment, special attention is paid to the prevention of decubitus ulcers, urosepsis and pulmonary complications. In addition to drug therapy, patients are administered massage, physiotherapy and climatetherapeutics.

As a rule, the treatment is carried out in special sanatoriums.

If the patient has no improvement, drug therapy has not brought the desired results, then maybe surgical intervention.

It helps to eliminate compression of the spinal cord. But surgery is only effective in the early stages of paralysis, that is, in the first year. After three years of paralysis, no operation will help.

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How to avoid complications

Usually with timely treatment of tuberculosis of the spine in most patients, clinical recovery occurs.

Mortality is practically absent. But this disease takes its toll and leaves behind a deformity of the spine.

One of the most serious complications of this disease is paraplegia, which occurs when compression of the spinal cord and leaf tissue becoming necrotic tissue, can also be caused by an abscess.

In the absence of adequate treatment the prognosis is not good, it could end in death.

Many people are concerned about contagious tuberculous spondylitis?

Actually the answer is in most cases positive, because tuberculosis of the spine usually occurs in patients with active pulmonary tuberculosis.

That is why the infection can spread through airborne droplets. If the patient spondylitis is the primary source of infection, the probability of infection is significantly reduced.

Prevention

Prevention of this disease boils down to the following recommendations:

  • early detection and treatment of patients;
  • annual x-ray study;
  • compliance with the elementary rules of personal hygiene;
  • timely vaccination of newborns.

Compliance with the above recommendations will reduce the likelihood of infestation.

Tuberculous spondylitis is a dangerous disease that can lead to death.

That is why when the first symptoms of the disease, it is important to consult a doctor and undergo a full examination. The sooner treatment begins, the greater the chances of recovery.