Overview
Tuberculosis (TB) is a potentially fatal contagious disease that can affect almost any part of the body but is mainly an infection of the lungs. It is caused by a bacterial microorganism, the tubercle bacillus or Mycobacterium tuberculosis. Although TB can be treated, cured, and can be prevented if persons at risk take certain drugs, scientists have never come close to wiping it out. Few diseases have caused so much distressing illness for centuries and claimed so many lives.
Tuberculous spondylitis is a spine infection associated with tuberculosis that is characterized by bone destruction, fracture, and collapse of the vertebrae, resulting in kyphotic deformity. The spinal canal can be narrowed by abscesses, granulation tissue, or direct dural invasion, leading to spinal cord compression and neurologic deficits.
Spinal tuberculosis may be caused by hematogenous spread from well-established, extra-spinal foci, or from visceral lesions by direct extension. The goals of treatment are to eradicate the infection and prevent or treat neurologic deficits and spinal deformity. Mortality from tuberculous spondylitis has decreased dramatically with the introduction of effective chemotherapeutic agents, which play an integral role in the management of spinal tuberculosis.
Currently used first-line drugs include isoniazid, rifampin, pyrazinamide, streptomycin, and ethambutol. Second-line agents that are used in special circumstances include ethionamide, cycloserine, kanamycin, capreomycin, prothionamide, and aminosalicylic acid. Surgery may be performed to drain abscesses, to débride sequestered bone and disk, to decompress the spinal cord, or to stabilize the spine for the prevention or correction of deformity.
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