Tuberculosis of the spine and spinal cord (original) (raw)
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Clinical-Morphological Aspects in Spinal Tuberculosis
Current Health Sciences Journal, 2018
Osteoarticular tuberculosis (OATB) Aim: The authors made a clinical morphological assessment of tissue samples from patients admitted in Surgical Departments of the Emergency County Hospital of Craiova, Romania, between 1990 and 2015, proved as presenting tuberculous lesions of the spine in the Department of Pathology of the same Hospital. Materials and Methods: The studied material consisted of bone, joint and sometimes muscle tissue fragments resulted from biopsies or surgical excisions from 7 cases coming out of 54 patients investigated in the above-mentioned period of time, where the established histological diagnosis was tuberculosis (TB). For diagnostic confirmation, Ziehl-Neelsen staining has been used as a rule but, in some cases, immunohistochemistry was also used. Results: TB lesions have prevailed in men and around the age of 50 years. Thoracic segment of the spine was the most involved. Epithelioid and giant Langhans cells dominated the inflammatory cellular population. ...
AN ANALYSIS OF CLINICO-RADIOLOGICAL AND HISTOPATHOLOGICAL CORRELATION IN TUBERCULOSIS OF SPINE
National Journal of Medical Research, 2013
Background: In the recent past, the use of computerized axial tomography and magnetic resonance imaging has helped to differentiate spinal tuberculosis from radiologically similar lesions. Objective: The objectives of the study was to assess how dependable clinical and radiological features are in establishing a diagnosis of spinal tuberculosis; and to identify other conditions which may have clinical and radiological features similar to those seen in patients with spinal tuberculosis. Methodology: Two hundred and sixty-seven consecutive patients with clinical and radiological features suggestive of tuberculosis of the spine treated over a period of five years were analysed. This retrospective case series analysis was done in a tertiary care hospital. The clinical presentation, radiological features and the erythrocyte sedimentation rate were correlated with the histopathological diagnosis on tissue obtained by open biopsy in 130 cases during surgery and in 137 cases by closed vertebral biopsy. Results: One hundred sixty-six cases were histologically proved as tuberculosis and 74 proved to be non-tuberculous lesions. Twenty-seven cases in which the biopsy was inconclusive were excluded from the study. The study demonstrated that tuberculous lesions were commoner in younger patients and the lesion was more often in the paradiscal region as compared to non-tuberculous lesions. However, all other clinical and radiological variables were not significantly different to enable reliable identification of tuberculous lesions on the basis of clinical and radiological features alone. Conclusion: It is recommended that all vertebral lesions suspected to be of tuberculous origin not responding to empirical antituberculosis therapy should have a definitive histopathological diagnosis and radiological investigation to facilitate appropriate treatment.
Clinical and Histopathological Correlation in Tuberculosis of Spine Biopsies
2021
ABSTRACT: BACKGROUND & OBJECTIVE: The tuberculosis (TB) of the spine is causing permanent deformities since long time. Earliest most possible accurate diagnosis is required to treat either TB or to exclude other lesions to avoid permanent disability. METHODOLOGY: This is a descriptive study conducted at pathology department of Lahore Medical & Dental College (LM&DC), Lahore from January 2017 to December 2019. All the spine biopsies received in Pathology department were included in the study irrespective of age and sex. Each biopsy was grossly and microscopically examined and reported by a histopathologist. RESULTS: Out of 386 specimens received, 189 (48.9%) were clinically diagnosed as tuberculosis. Out of these 189 cases, 127 were confirmed on histopathological examination showing clinicopathological correlations in 67.19 % of cases. The rest 62 (32.80%) of the cases were reported as chronic non specific inflammation (38), degenerative changes (11), metastatic tumor (04), and atypi...
Atypical forms of spinal tuberculosis
Acta Neurochirurgica, 1987
Twenty-three patients with atypical forms of spinal tuberculosis treated between 1975 and 1985, are described. All presented with signs and symptoms of compression of the spinal cord or cauda equina, ranging from paraesthesiae and increasing weakness of extremities to paraplegia and loss of sphincter control. None of them showed visible or palpable spinal deformity nor the typical radiographic appearance of destruction of the intervertebral disc and the two adjoining vertebral bodies. These atypical forms constituted about 12 percent of all the cases of spinal tuberculosis seen (a total of 190 cases); and fell into three well-defined groups: those with the involvement of neural arch only; those with the inolvement of a single vertebral body; and, those without bony involvement. The correct surgical approach in these groups was found to be different: spinal cord compression caused by the tuberculous disease of the neural arch was best treated by laminectomy; whereas single vertebral body disease required an anterior or anterolateral approach. Spinal computerized tomography was helpful in defining the extent of disease and planning the surgical approach. Histological confirmation of tuberculosis was obtained in all the cases and acid fast bacilli (A.F.B.) were found in, and cultured from, the biopsy specimens of 18 cases.
A clinical study and classification of posterior spinal tuberculosis
International Orthopaedics, 1985
Tuberculous involvement of the posterior elements of the spine is uncommon. Review of the literature reveals little information and there is scant mention of this subject in standard textbooks of orthopaedics. A study of 27 cases of such lesions seen over 6 years is presented, drawn from two separate centres, 21 from Central India and 6 from South Eastern Iran. The clinical presentation, investigations and treatment are analysed. A new four point classification is described based upon the site of the lesion, the stage of the lesion, associated lesions and neurological deficit. L'atteinte tuberculeuse des éléments postérieurs du rachis n'est pas fréquente. La revue de la littérature n'apporte que peu d'informations et les traités classiques d'orthopédie ne donnent sur ce sujet que des notions sommaires. On présente ici l'étude de 27 cas de tuberculose vertèbrale postérieure observés en 6 ans, issus de deux centres distincts, 21 du centre de l'Inde et 6 du Sud-est de l'Iran. Le tableau clinique, les examens complémentaires et le traitement sont analysés. Les auteurs proposent une classification nouvelle en quatre points tenant compte de l'emplacement et du stade évolutif, de l'atteinte osseuse, des lésions associées et du déficit neurologique.
An atypical presentation of tuberculosis of the spine
Spinal Cord, 1996
We present a retrospective analysis of 684 patients operated on for a herniated lumbar intervertebral disc. Of the 87 patients with a failed back syndrome, 12 were confirmed to have tuberculous infection of the same disc interval. These patients responded satisfactorily to bracing and a short course of anti-tubercular chemotherapy. Histopathological confirmation of the disease was obtained by CT guided biopsy, and only a few of the patients required repeat surgery. This study highlights one of the atypical presentations of tuberculosis of the spine as a herniated lumbar intervertebral disc and a cause of a failed back syndrome.
Microbiological diagnosis of spinal tuberculosis
International Orthopaedics, 2012
Purpose The purpose of this study was to review the clinical features and diagnosis of spinal tuberculosis cases reported in the literature. Methods A medical literature search in the Medline Pubmed database was undertaken to review tuberculosis spinal infection and extra-pulmonary tuberculosis diagnosis improvement. We introduced the following search items and boolean operators: "spinal infection", "spinal tuberculosis infection", "microbiological diagnosis of spinal tuberculosis" and "spinal tuberculosis PCR." Single cases or series without microbiological diagnosis were rejected. Manuscript language was restricted to Spanish, French, and English versions. Results and conclusions Spinal tuberculosis is more common in developing countries and is probably underdiagnosed. Delayed diagnosis is characteristic; it worsens the prognosis and increases morbidity. The microbiological diagnosis is crucial for several reasons. Despite surgical treatment, medical treatment with anti-tuberculous drugs is always necessary. A total of 20-40% of the spinal tuberculosis patients show another locus of infection. Pulmonary location can become a public health problem. Previously treated patients for other tuberculosis locations, incomplete treatments, or poor adherence can change the M. tuberculosis sensitivity pattern. Drug resistance test becomes a major need in the microbiology laboratory. PCR diagnostic techniques advance the diagnosis and increase the sensitivity and specificity rate.
Spine tuberculosis affecting multiple vertebrae at different levels is a rare disease. This case report describes a condition of multiple spine tuberculosis of vertebral bodies number T6, T12 and L1 in 53-year-old man. The patient presented backache for two months that followed by paraplegia due to compression of the spinal cord at the level of T12. This was caused by tuberculous necrotic material. Plain radiographs revealed signs of spine tuberculosis. Myelographs demonstrated the spinal cord compression at the level of T12. In addition, the operative material was used to confirm the diagnosis of spine tuberculosis by showing positive culture of Mycobacterium tuberculosis and signs of tuberculosis on histopathological examination. A laminectomy was made to ease the compression and a combination of anti-tuberculous chemotherapy was given to the patient for one year. Gradual recovery was initiated within five weeks after operation that was assisted by physiotherapy. Good improvement was gained after six months whereas complete recovery was obtained after one year. It is recommended, therefore, when spine tuberculosis is detected in certain vertebra, x-ray of other ones should be made to exclude the possibility of other spine infection.
Clinico- radiological manifestation of TB spine and its complications
IP innovative publication pvt. ltd, 2019
Background: Vertebral tuberculosis is the most common form of skeletal tuberculosis and it Constitute 50% of all skeletal tuberculosis. Nearly 88% of cases of chronic infection of spine are of tuberculosis in origin. In developing countries diagnosis of tuberculosis of bone and joints can reliably made on clinical and radiological examinations. Here we had taken up the study of clinic radiological manifestation of TB spine and its complications. Methodology: Patients attended OPD and IPD of Chest and TB Dept. of VSS Medical College and hospital, Burla with TB spine were taken up for study after taking proper consent. The patients who showed clinical evidence of TB spine were selected basing on hematological findings, radiological examinations, Mantoux test with clinical signs and symptoms for the diagnosis. Children under 10 years were excluded from the study. Results: 30 patients with TB spine were taken up for the study. It was found that TB spine is more prevalent among males then females with highest incidence in the age group of 41 to 50 years. Majorities of patient with low socioeconomic status. Dorso-lumabar vertebra is the most commonly involved. Back pain and spinal tenderness are the most common features. About 16.6% cases pulmonary involvement seen. There is moderate degree of anemia with raised ESR seen in 93.2% of cases. About 80% cases found to have tuberculin positive. Bony destruction and joint space reduction seen in most of the cases. Conclusion: Patients having pain in back, fever and weight loss should be investigated in the line of tuberculosis. Of spine so that early diagnosis can be done and complications could be prevented. Keywords: Tuberculosis, Spine.