Spinal tuberculosis is a rare form of tuberculosis where the Mycobacterium tuberculosis bacteria colonize the spine, leading to damage of the spinal discs and subsequent 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 there are a number of treatments 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, after the physician who researched it in the 1800s, this condition can occur when tuberculosis bacteria spread through the vascular system to the spine. As the bacteria grow, they erode the disks between the vertebrae, causing the vertebrae to collapse. This puts pressure on the spine, leading to a curving 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 inexplicable weight loss, paired with fever from the active infection. Some patients develop neurological problems like difficulty walking or paralysis in response to the damage to the spine. A medical examination 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 the tell-tale signs of damaged spinal discs.
Treatment for spinal tuberculosis starts with anti-tuberculosis medications, which may need to be taken for six months or more. If a severe deformity is present, surgery to decompress the spine may be necessary to prevent spinal cord injury. Surgery is usually needed in fewer 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 nations, where people may lack access to tuberculosis treatment, or cannot afford to complete courses of tuberculosis medication. It is also a potential complication of acquired immune deficiency syndrome (AIDS) and can be seen in populations of AIDS patients around the world, along with tuberculosis of the lungs. People with AIDS are more prone to developing a wide variety of infections due to decreased immune functionality, and their lack of immune defenses can make them vulnerable to rare complications like spinal tuberculosis.