A18.01

Clinical Causes: Primarily caused by the spread of Mycobacterium tuberculosis from the lungs or other parts of the body through the bloodstream. Usually results from hematogenous dissemination of TB bacteria rather than direct invasion. Can occur in individuals with weakened immune systems, such as those with HIV/AIDS, malnutrition, or diabetes. In rare cases, may develop from direct extension from nearby infected tissues or through direct trauma.

Key Symptoms: Persistent back pain, often localized to the affected area of the spine. Malaise and fatigue, which may be ongoing or gradual. Fever and night sweats, especially in active cases. Weight loss and loss of appetite over time. Neurological symptoms such as numbness, weakness, or paralysis if the spinal cord or nerve roots are compressed. Deformity of the spine, leading to a curvature or kyphosis. Tenderness over the affected vertebrae.

Diagnosis Path: A thorough medical history and physical examination focusing on back pain, systemic symptoms, and risk factors. Imaging studies such as X-rays, MRI, or CT scans to visualize bone destruction, abscess formation, and spinal deformity. Laboratory tests including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and positive tuberculin skin test (TST) or interferon-gamma release assays (IGRAs). Microbiological confirmation through biopsy or aspiration of affected tissue to identify Mycobacterium tuberculosis, using acid-fast bacilli (AFB) staining, culture, or molecular methods like PCR.

Treatment Protocols: Prolonged course of anti-tubercular medications, usually lasting 9 to 12 months, including drugs such as isoniazid, rifampicin, ethambutol, and pyrazinamide. Monitoring for drug adherence and potential side effects throughout the treatment duration. Surgical intervention in cases with significant spinal deformity, neurological deficits, abscesses, or instability. Surgical options may include debridement, stabilization, or decompression procedures. Rest, immobilization, and physical therapy to support spinal stability and improve mobility. Management of any complications, such as neurological recovery or correction of deformities.