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At least 19 recordsLinked to original sources
PubMed1999

[Contribution of spiral CT scan and MRI in spinal tuberculosis].

Spinal tuberculosis is the most frequent skeletal involvement in tuberculosis. The purpose of this study was to demonstrate the importance of the MRI and the helicoidal CT scan in the diagnosis of spinal tuberculosis. A retrospective study was conducted in 23 patients with spinal tuberculosis. The methods of investigation were helicoidal CT scan in 15 patients and MRI in the other eight patients. In the all cases with helicoidal CT scan, the features of the spinal tuberculosis were seen as an anterior vertebral body destruction with a paraspinal or epidural extension in 12 cases and a sequestrum formation in 5 cases. The analysis with helicoidal CT scan showed a gibbous deformity in 5 cases, a disk space narrowing in 14 cases and evaluated the extension very well. The MR imaging features showed one case in an early stage without features on the plain radiographs, and detected 3 cases of intramedullary lesions. A disruption of the longitudinal posterior vertebral ligament was found in one case and skip lesions at the granulomatous stage in 2 cases. MRI is superior to CT scan even helicoidal CT at the early lesion stage, skip lesions and the ligamentous or medullary lesions. For other lesions (bone, disk, extension), the MRI and CT scan are the same with an advantage for CT scan in osseous lesions.

Adult↗
PubMed2005

Modern imaging of spinal tuberculosis.

Spinal tuberculosis (Pott disease) is uncommon in developed countries. On imaging studies diagnosis of this lesion may not be considered or it might be mistaken for pyogenic osteomyelitis. Features most strongly indicative of a diagnosis of spinal tuberculosis are relative sparing of the disc space, large paraspinous abscesses, a thick rim of enhancement around the paraspinous and intraosseous abscesses, calcifications within the paraspinous collections, and a fragmentary pattern of osseous destruction. As the disease progresses, there is worsening of the osseous destruction, leading to collapse of the vertebral body and eventual progression to kyphotic deformity. Based on recent experience, the authors review the major imaging characteristics associated with spinal tuberculosis and describe the typical course of the disease as documented on plain radiographs, computerized tomography scans, and magnetic resonance images.

Calcinosis↗
PubMed2002

The outcome of allografts and anterior instrumentation in spinal tuberculosis.

Spinal tuberculosis is the most common form of osteoarticular tuberculosis. Fractures, slippage, and increasing deformity have been reported with the use of autologous rib grafts after anterior spinal decompression. Forty-one patients with neurologic deficits caused by spinal tuberculosis had radical anterior decompression, and the anterior column was reconstructed with fresh-frozen femoral allografts and stabilized with a single-rod screw construct. Antituberculous therapy was administered for 12 months and complete neurologic recovery occurred in 32 patients. The incorporation of allografts commenced between 12 and 18 months. Fusion and remodeling was observed in 33 patients and partial remodeling with fusion was observed in eight patients at a mean followup of 6.4 years. Forty-two percent correction of the kyphosis was achieved and there were no cases of fracture or late sepsis. Fresh-frozen allografts and anterior instrumentation are superior to rib grafts in supporting the anterior spinal column, and although fusion occurred late, the grafts remained stable.

Adolescent↗
PubMed2002

The problem of deformity in spinal tuberculosis.

Spinal tuberculosis is the most common cause for a kyphotic deformity in patients in many parts of the world. There is an average increase of 15 degrees deformity in all patients who are treated conservatively and 3% to 5% of patients may end up with a deformity that is greater than 60 degrees. The progress of deformity occurs in two distinct phases: Phase I, which includes the changes in the active phase, and Phase II, which includes changes after the disease is cured. The progress of deformity is influenced by the severity of the angle before treatment, the level of the lesion, and age of the patient. Adults have an increase less than 30 degrees during the active phase with no additional change. Children, in contrast, have significant changes even in the healed phase of the disease. During the growth spurt, there is worsening of the deformity in 39% (Type I progression), an improvement in 44% (Type II), and no change in 17% (Type III). Children at risk of late progressive deformity can be identified early by the presence of spine-at-risk radiologic signs. Surgery for preventing deformity must be done earlier rather than later and in patients with severe disease, stabilization by the use of posterior and anterior instrumentation is necessary to obtain a good outcome.

Adult↗
PubMed2002

Spinal cord compression of dual etiology, multiple myeloma and spinal tuberculosis.

Spinal cord compression as an initial manifestation of multiple myeloma is a well-known phenomenon. We report for the first time a patient with spinal cord compression of dual etiology, multiple myeloma and spinal tuberculosis, treated successfully by local radiotherapy, chemotherapy and an antituberculous regimen.

Combined Modality Therapy↗
PubMed2001

Spinal tuberculosis.

Spinal tuberculosis is an important and potentially crippling disease, but if recognized early and treated energetically it can be brought under control, often with very gratifying results. Knowledge of the exact bacteriology and sensitivity pattern of the organisms involved can be very helpful indeed, and should be sought where possible.

Humans↗
PubMed2002

Atypical spinal tuberculosis.

Typical spinal tuberculosis is readily diagnosed and treated. Certain atypical clinical and radiologic presentations of spinal tuberculosis are described. Failure to recognize these presentations may lead to delay in diagnosis and initiation of treatment. In some atypical forms of the disease, this may have disastrous consequences. The current authors present a new classification for atypical spinal tuberculosis and describe the various presentations. The role of advanced imaging studies such as computed tomography scanning and magnetic resonance imaging and imaging-guided aspiration cytology is discussed.

Diagnosis, Differential↗
PubMed1997

Vertebral arch or posterior spinal tuberculosis.

Posterior spinal tuberculosis or arch tuberculosis is a form of skeletal tuberculosis that selectively involves the vertebral arch. It may mimic skeletal neoplasm clinically and radiographically. Although posterior spinal tuberculosis has been reported in developing countries it has rarely been found in the United States. As a result, there is limited information about this entity in the US literature. We are presenting our experience in a patient born in the United States.

Antitubercular Agents↗
PubMed2004

Spinal tuberculosis: with reference to the children of northern India.

BACKGROUND: Tuberculosis is a necrotizing bacterial infection with protean manifestation and wide distribution. There has been a great fall in the prevalence of tuberculosis in the United States since 1990, although the impact of acquired immunodeficiency syndrome (AIDS) has increased the resurgence of tuberculosis (TB). Spinal tuberculosis is the commonest form of skeletal tuberculosis. In this article, an overview of spinal tuberculosis and the personal experience of 19 children with spinal tuberculosis are presented. All the children required surgical intervention, because they manifested neurological deficit. PATHOGENESIS AND CLINICAL FEATURES: The spinal tuberculosis is a result of hematogenous dissemination from primary focus in the lungs or the lymph nodes. The central type of vertebral tuberculosis spreads along with Batson's plexus of veins, while paradiscal infection spreads through the arteries. The anterior type of vertebral body tuberculosis results from the extension of the abscess beneath the anterior longitudinal ligament and periosteum. Two types of bone and joint tuberculosis are recognized: the caseous, exudative type with abscess formation, which is more common in children, and the granular type is frequent in adults. Only 7 of the 19 children had an abscess, while 10 manifested mainly granulation tissue. Although spinal tuberculosis is an extradural disease, 2 children had intramedullary granulomas and presented a tumor-like syndrome as rare manifestations. It was interesting to encounter intradural granulation and organized intradural granuloma causing cord compression in 2 children. A frank abscess with clumping of nerve roots was encountered in the cauda of another child without vertebral involvement. There is a controversy regarding the age predilection of the disease; it is documented that it is a disease of adults in affluent countries, and a disease of the first three decades in other regions. DIAGNOSIS: Magnetic resonance imaging is extremely useful in diagnosing the difficult and rare sites of disease like the craniovertebral junction. It detects the marrow changes, exudative and granulation types, extra- and intradural disease, and radiological response to treatment in the early follow-up period around 6-8 weeks. TREATMENT: Opinion varies regarding the operative indication for Pott's spine. A large group of surgeons perform debridement and decompression in all cases, irrespective of neurological involvement. Others perform operative decompression only in those patients who do not respond to chemotherapy. We did surgical interventions in children with moderate to severe neurological deficits manifesting radiological compression of their neuraxis. Depending on the site of involvement and type of disease the surgical approach was decided in individual cases. Two children with healed Pott's spine also required surgery because of their spinal deformations, which caused gradual neurological deficits and pain in both. Prognosis depends on many factors; the magnitude of cord compression, duration of neural complication, age and general condition of patient. Fifteen of our children made a remarkable recovery. Children with paraplegia also made an excellent recovery of their strength and sensations.

Child↗
PubMedDate not supplied

Atypical spinal tuberculosis in children.

Spinal tuberculosis characteristically involves two contiguous vertebral bodies with narrowing of the disk space. We report on 11 children with atypical spinal tuberculosis. Three had disease confined to a single body, four had extradural extraosseous involvement presenting as an abscess, and isolated infection of the neural arch was seen in four children. Seven children had neurological involvement. Treatment included posterior decompression for the extradural extraosseous involvement, biopsy and drainage for the neural arch infection, and anterior decompression and fusion for the single-body disease. The patients had antituberculosis treatment for 18 months, and all seven children with neurological involvement recovered.

Abscess↗
PubMed1998

[A case of miliary tuberculosis with multiple cerebral tuberculoma and spinal tuberculosis owing to total delay].

We reported a case of miliary tuberculosis with multiple cerebral tuberculoma and spinal tuberculosis. The case was a 37 year old man. In the last sixteen months to the first visit to a hospital, he has been suffering from low grade fever, cough, and back pain, but he bared his symptoms without any therapy. At a hospital he first visited, he was told that he might have a malignant disease, which prevented him to visit the hospital because of a fear for his disease. Six months later, he was admitted to other hospital because of severe back pain. At last, he was diagnosed as tuberculosis and referred to our hospital. By the examinations on admission he was diagnosed as multiple cerebral tuberculoma and spinal tuberculosis, and anti-tuberculous therapy was started. It is thought that his severe disease status on admission is caused by the total delay, namely the delay in visiting a doctor and the doctor's delay in making diagnosis.

Adult↗
PubMed1976

Some problems in diagnosis and management of spinal tuberculosis.

In Victoria spinal tuberculosis is now rare in childhood. Some features of the disease in adults are described. A paravertebral abscess, although a late feature of the disease, is commonly present before a diagnosis is made. Antituberculosis drug therapy has greatly altered the pattern of healing of both the bone lesion and, in contrast to the era before chemotherapy, the healing of the abscess is no longer the dominant factor in the healing of the bone lesion. The controversy about radical surgery is discussed.

Abscess↗
PubMed2004

Paleopathological examination of medieval spines with exceptional thoracic kyphosis most likely secondary to spinal tuberculosis. Historical vignette.

Spinal tuberculosis (TB) infrequently involves more than one to three vertebrae, and kyphotic angulation of greater than 30 degrees is rare in paleopathological specimens and clinical studies. The authors describe findings obtained in two spines (dating from the Early and Late Middle Ages). Spinal TB was present in both as well as sharply angulated kyphosis (approximately 180 degrees) resulting from complete destruction of five and seven vertebral bodies, respectively. In these two specimens obtained in individuals older than 12 years of age at the time of death we observed no involvement of the disease in posterior vertebral elements, and the laminae showed osseous fusion without signs of infection. The osseous diameter of the spinal canal was not narrowed in either case. These findings are discussed in the context of modern medical knowledge and paleopathological and genetic examinations.

History, Medieval↗