What is a tuberculous spondylitis of the spine, symptoms and treatment?
Inflammatory processes of the spine, caused by infectious etiology, in medicine called tuberculous spondylitis. Feature of tuberculous spondylitis is the fact that in adults the disease almost never occurs. Most often affects vertebrae in childhood and adolescence. with In case of an illness it is important to start treatment in time, otherwise it can turn into a complicated shape, which cannot be treated. With advanced tuberculous spondylitis is a high probability of fatal outcome.
The Cause of the disease is considered to be the ingress of the tubercle Bacillus from the lungs to the spine. Microscopic sticks into the cloth of the spine and reproduce. The process of infection can last up to 2 years. The wand affects the bone tissue of the vertebrae and softens it. In the place of localization of the bacteria formed an abscess, which is filled with a purulent mass. Therefore, you may marvel at the entire spine. The disease can cause the following reasons:
- the large number of bacilli in the environment. In this case, there is a risk of bacterial infection of people living in this area;
- to environment pollution, poor hygienic conditions;
- reduced immunity in childhood and adolescence
- chronic disease
- failure of the thyroid and pancreas, which causes hypothyroidism and diabetes;
- postoperative status after transplantation of bodies;
- the use of hormonal drugs.
The Disease can be localized in any part of the spine: cervical, thoracic and lumbosacral.
The difficulty of diagnosis in tuberculous spondylitis are associated with the disease. The fact is that in the early stages of the disease is not affecting the overall condition of the body, and its symptoms do not manifest. Often physicians may not recognize symptoms and diagnose the disease, as osteochondrosis. This greatly complicates treatment.
The telltale signs appear already at the stage of necrosis of the bone. The vertebrae start to collapse. This process extends to the surrounding vertebrae. As a result of this impact collapse processes of the vertebra and formed paravertebral wandering abscess. The first symptoms of tuberculous spondylitis are pain in the region of localization of the abscess and immobility. All depends on the location of the abscess. If it is the upper spine may be numbness of the hand with partial paralysis. This pattern can be observed during exercise. After that the patient restrict locomotor activity, there is stiffness and limited mobility of the spine. These symptoms are similar to those in osteochondrosis.
In tuberculous spondylitis is dominated by pain during palpation of the affected vertebra. However, the pain appears on pozdnysheva disease. Destruction of bone tissue leading to deformation of the spine, causing spinous process protrudes in the posterior part and fixes the situation. All this can lead to fracture of the spine and the appearance of the hump. The main characteristics of tuberculous spondylitis are as follows:
- back pain
- pain at the site of localization of abscess;
- numbness and paralysis of the limbs.
If not treated timely, it will experience a further fracture of the vertebrae, which formed a triad Pott: abscesses, deformity of the spine and paralysis of the muscles. In addition to these symptoms there is an increase in body temperature, loss of appetite and increased sweating.
The Disease first affects the lungs, a cough, pain in the sternum and shortness of breath. Then there is General malaise, decreased working capacity and attention, headache. This somatic state is observed within two years. If the disease is delayed for three years, to cure the patient. In the tissues of the bones of the spine are irreversible processes.
The Differential diagnosis of the disease involves the following tests:
- blood analysis, including the determination of biochemical compounds: bilirubin, protein, transaminases, alkaline phosphatase, urea, thymol and creatinine;
- the study of blood serum (immunoglobulin);
- rheumatology samples;
- x-ray study;
- CT scan and ultrasonography (ultrasound)spine.
For accurate diagnosis needs examination therapist, neurologist, traumatologist, rheumatologist and a TB.
Tactics and methods of therapy
The Treatment of tuberculous spondylitis treatment at the hospital. The destruction of the pathogen directed treatment with rifampicin, which should be taken 30 minutes before meals. It is also prescribed isoniazid and streptomycin.
For the treatment of symptomatic pain apply dicloberl (diclofenac and daklak). In the treatment can also be used such analgesics, Movalis, meloxicam, xefocam intramuscularly. For the treatment is often combined injection and tablet formulations: ibuprofen, nimid, diclofenac . As hormonal substitutes are used prednisolone, sodium chloride, Celeste.
To maintain muscle tone mydocalm is used in injection and tablet milgamma and neurorubine.
In exceptional cases, performed surgery. The purpose of these operations is optimally mounted using a plaster cast spinal column. To do this, use two types of surgery: necrectomy and abscessation.
The Effectiveness of this surgery checked medical practice and limited by the terms of the disease. They spend the first 9-12 months after a partial numbness or paralysis. Only in this period doctors guarantee the full recovery of patients. Later in such a positive dynamics is not observed. Tuberculous spondylitis may be complicated by the violation of motor activity, intestinal diseases, kidney and decrease in reproductive function.
As precautionary measures, use of professional examinations, which are held annually. Especially for those whose activity is connected with people. Such examination can identify the beginning of tuberculosis and thus prevent the further development of spondylitis. For the tubercle Bacillus are considered to be favorable unsanitary conditions. Always try to observe the rules of personal hygiene, to maintain adequate sanitary conditions on the premises, often ventilate.
Chronic disease of the spine can successfully be cured with prompt diagnosis and proper treatment.