Patients with tuberculosis of any part of the spine may complain of pain localized to that area, fever (especially in the evenings), weight loss, loss of appetite and a generalized feeling of being unwell. Their pain may be especially worse at night or during rest. Tuberculosis of the spinal bones can easily spread to the spinal cord resulting in weakness and numbness of extremities, paralysis and alteration of urine and motion pattern. It is this proximity to the spinal cord that makes TB spine a problem that cannot be taken lightly.
An X-ray followed by an MRI (may need contrast) will be required to make a diagnosis of Spinal TB. A basic work up for TB should include a Complete Blood Count (CBC), ESR, Liver Function Test (LFT) and a Chest X-ray.
Once a diagnosis of spine tuberculosis is confirmed, your doctor will start you on anti TB treatment (ATT) for 9-12 months. This will typically comprise of 4 drugs – Isoniazid, Rifampicin, Pyrazinamide and Ethambutol. Most patients improve on ATT but a few patients may need Spine Surgery in addition to ATT.
Your Spine Surgeon may recommend you to undergo a biopsy/FNAC to confirm the diagnosis of TB. A biopsy/FNAC is also recommended if your Spine Surgeon suspects Multi Drug Resistant TB (MDR – TB). Other infections, cancers and tumors can look like TB on X-rays and MRI. Therefore, a biopsy will confirm tuberculosis and rule out the other possibilities with absolute confidence.
