{"id":26217,"date":"2022-06-10T15:33:12","date_gmt":"2022-06-10T19:33:12","guid":{"rendered":"http:\/\/osteomag.ca\/tuberculosis-of-the-spine\/"},"modified":"2024-08-09T07:08:56","modified_gmt":"2024-08-09T12:08:56","slug":"tuberculosis-of-the-spine","status":"publish","type":"post","link":"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/","title":{"rendered":"Tuberculosis of the spine"},"content":{"rendered":"\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #000000;color:#000000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #000000;color:#000000\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Introduction\" >Introduction<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Epidemiology_of_Tuberculosis\" >Epidemiology of Tuberculosis<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Global_Burden_of_Tuberculosis\" >Global Burden of Tuberculosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Geographic_Distribution\" >Geographic Distribution<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Pathophysiology_of_spinal_tuberculosis\" >Pathophysiology of spinal tuberculosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Causes_of_spinal_tuberculosis\" >Causes of spinal tuberculosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Symptoms_of_spinal_tuberculosis\" >Symptoms of spinal tuberculosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Types_of_tuberculous_lesions_in_the_spine\" >Types of tuberculous lesions in the spine<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Predisposing_factors\" >Predisposing factors<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Regional_distribution_of_spinal_tuberculosis\" >Regional distribution of spinal tuberculosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Radiographic_signs_of_spinal_tuberculosis\" >Radiographic signs of spinal tuberculosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/osteomag.ca\/en\/tuberculosis-of-the-spine\/#Reference\" >Reference<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-ec93316077cc9423142c1895206016d5\"><span class=\"ez-toc-section\" id=\"Introduction\"><\/span>Introduction<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The incidence of tuberculosis (TB) is on the rise globally, presenting a significant public health challenge. Several factors contribute to this increase, including the growing number of immunocompromised individuals, the emergence of drug-resistant strains of <em>Mycobacterium tuberculosis<\/em>, and an aging population. Among these factors, HIV stands out as the primary risk factor for the reactivation of latent TB infections, as it severely weakens the immune system, making individuals more susceptible to the disease.<\/p>\n\n\n\n<p>According to the World Health Organization, approximately one-third of the world&#8217;s population is infected with <em>Mycobacterium tuberculosis<\/em>. It is considered one of the leading causes of death and disability worldwide. Alarmingly, about one-fifth of newly diagnosed TB cases are extrapulmonary, meaning the infection occurs outside the lungs, and the spine is involved in 50% of bone and joint TB cases. This spinal involvement can lead to severe complications, including deformities and neurological deficits.<\/p>\n\n\n\n<p>Tuberculosis has been recognized as a disease since antiquity, with descriptions found in ancient texts and evidence found in skeletal remains. In 1779, Sir Percival Pott made significant contributions to the understanding of spinal TB by describing its clinical presentation, which includes kyphotic deformity and neurological deficits in European patients. His observations laid the foundation for future research and treatment of spinal tuberculosis.<\/p>\n\n\n\n<p>The 20th century marked a turning point in the fight against tuberculosis. The discovery of <em>Mycobacterium tuberculosis<\/em> as the causative pathogen led to significant advancements in TB management. The development of the Bacillus Calmette-Gu\u00e9rin (BCG) vaccine provided a crucial tool for preventing TB, especially in children. Additionally, advances in diagnostic modalities, chemotherapeutic agents, and surgical procedures revolutionized the treatment of spinal tuberculosis, offering hope for recovery and improved quality of life for affected individuals.<\/p>\n\n\n\n<p>Despite these advances, tuberculosis has experienced a resurgence in recent years, particularly in developed countries. This resurgence is largely attributed to the increase in global migration, which has led to the spread of TB across borders and into new populations. This &#8220;global migration phenomenon&#8221; has posed a significant challenge to the international community, as TB cases are often complicated by drug resistance and the presence of co-infections like HIV.<\/p>\n\n\n\n<p>Addressing the resurgence of tuberculosis requires a multifaceted approach. Public health initiatives must focus on early detection and diagnosis, effective treatment regimens, and robust vaccination programs to prevent the spread of TB. Additionally, addressing the social determinants of health, such as poverty and access to healthcare, is crucial for controlling the disease. Research efforts continue to explore new diagnostic tools, treatments, and vaccines to combat the evolving threat of tuberculosis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading LC20lb DKV0Md has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-f3f17d28a1123394a9457576ddcc65c4\"><span class=\"ez-toc-section\" id=\"Epidemiology_of_Tuberculosis\"><\/span>Epidemiology of Tuberculosis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-8ff374e213c13d2f733f4574aee46d8a\"><span class=\"ez-toc-section\" id=\"Global_Burden_of_Tuberculosis\"><\/span><strong>Global Burden of Tuberculosis<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>Tuberculosis (TB) remains one of the world&#8217;s most significant public health challenges, with a profound impact on global health. According to the World Health Organization (WHO), TB is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent, surpassing even HIV\/AIDS. In 2022, it was estimated that around 10.6 million people fell ill with TB, and 1.6 million people died from the disease. These numbers underscore the enduring threat TB poses, particularly in low- and middle-income countries.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-vivid-cyan-blue-color has-text-color has-link-color wp-elements-cd842d93a8b4372d52bb042b54f2a4cd\"><span class=\"ez-toc-section\" id=\"Geographic_Distribution\"><\/span><strong>Geographic Distribution<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>TB is a disease of global reach but is disproportionately concentrated in certain regions. The highest burden is found in South-East Asia and Africa, accounting for nearly 70% of all TB cases. India, China, Indonesia, the Philippines, Pakistan, Nigeria, and South Africa are among the countries with the highest TB burdens, collectively accounting for two-thirds of the global total. This uneven distribution reflects the socioeconomic disparities, healthcare access challenges, and varying levels of healthcare infrastructure that influence TB transmission and treatment outcomes.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img decoding=\"async\" width=\"810\" height=\"480\" src=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1.png\" alt=\"L\u2019attribut alt de cette image est vide, son nom de fichier est 2021-01-15_18-35-31a.png.\" class=\"wp-image-44163\" style=\"width:810px;height:auto\" srcset=\"https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1.png 810w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-540x320.png 540w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-80x47.png 80w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-768x455.png 768w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-709x420.png 709w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-150x89.png 150w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-300x178.png 300w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-600x356.png 600w, https:\/\/osteomag.ca\/wp-content\/uploads\/2024\/08\/image-1-696x412.png 696w\" sizes=\"(max-width: 810px) 100vw, 810px\" \/><\/figure>\n<\/div>\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-07ba642fe54bfb43b289447c11b613ea\"><span class=\"ez-toc-section\" id=\"Pathophysiology_of_spinal_tuberculosis\"><\/span>Pathophysiology of spinal tuberculosis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The pathophysiology of spinal tuberculosis involves several steps and responses of the immune system to Mycobacterium tuberculosis infection. The following is a general description of the pathophysiology of this condition:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Initial Infection:<\/strong>\u00a0Spinal tuberculosis often begins with an initial infection of the respiratory tract, where Mycobacterium tuberculosis bacteria are inhaled. Once in the lungs, the bacteria can invade lung cells and escape destruction by the immune system.<\/li>\n\n\n\n<li><strong>Hematogenous Spread:<\/strong>\u00a0When bacteria manage to evade the immune response in the lungs, they can enter the bloodstream. Hematogenous spread allows the bacteria to reach other organs and tissues, including the spine.<\/li>\n\n\n\n<li><strong>Granulomas Formation:<\/strong>\u00a0Mycobacterium tuberculosis has the ability to resist clearance by immune cells. Cells of the immune system surround the bacteria, forming structures called granulomas. These granulomas are clumps of immune cells that attempt to isolate and contain the infection.<\/li>\n\n\n\n<li><strong>Inflammatory Response:<\/strong>\u00a0Granuloma formation triggers an inflammatory response in the spine. This can cause tissue damage, including bone destruction.<\/li>\n\n\n\n<li><strong>Abscess Formation:<\/strong>\u00a0In response to infection, abscesses may form around the spine. These pockets of pus are the body&#8217;s attempt to contain the infection and can be seen on medical images.<\/li>\n\n\n\n<li><strong>Spinal Deformity and Complications:<\/strong>\u00a0Inflammation and tissue destruction can lead to spinal deformities, vertebral compressions, and other complications. The injuries can affect the stability of the spine and, in some cases, compress nerve structures, leading to neurological symptoms.<\/li>\n\n\n\n<li><strong>Chronic Immune Response:<\/strong>\u00a0In cases where the infection is not cleared, a chronic immune response may persist. This can lead to scarring, permanent changes in bone structure, and long-term complications.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-b75eafe8bfd37e0cd36027235440b33a\"><span class=\"ez-toc-section\" id=\"Causes_of_spinal_tuberculosis\"><\/span>Causes of spinal tuberculosis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Spinal tuberculosis is primarily caused by infection of the spine with the bacteria Mycobacterium tuberculosis. This infection can occur in a number of ways, and several factors can contribute to its development. Here are some causes of spinal tuberculosis:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Primary Lung Infection:<\/strong>\u00a0Spinal tuberculosis is often the result of a primary lung infection with Mycobacterium tuberculosis. When a person inhales droplets containing the bacteria, they can develop a lung infection that, in some cases, spreads to other parts of the body, including the spine.<\/li>\n\n\n\n<li><strong>Reactivation of Latent Infection:<\/strong>\u00a0In some cases, spinal TB can result from reactivation of a latent TB infection. People who have been infected with the bacteria but have not developed symptoms may have the infection reactivate later in life, sometimes affecting the spine.<\/li>\n\n\n\n<li><strong>Bloodborne Contamination:<\/strong>\u00a0Spinal infection can occur through bloodborne transmission, meaning that bacteria reach the spine through the bloodstream. This can occur when the bacteria enter the bloodstream from another part of the body.<\/li>\n\n\n\n<li><strong>Weakened Immune System:<\/strong>\u00a0Individuals with weakened immune systems, either due to diseases such as HIV\/AIDS or due to immunosuppressive medications, are more likely to develop spinal tuberculosis.<\/li>\n\n\n\n<li><strong>Migration of Extravertebral Infection:<\/strong>\u00a0In some cases, tuberculous infection may spread to the spine from extravertebral sites, such as adjacent lymph nodes.<\/li>\n\n\n\n<li><strong>Genetic Factors:<\/strong>\u00a0Some studies suggest that there may be genetic predispositions to tuberculosis, although the precise genetic contribution is not fully understood.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-bb49ca2a4c9331f42cbb4c9d860559a2\"><span class=\"ez-toc-section\" id=\"Symptoms_of_spinal_tuberculosis\"><\/span>Symptoms of spinal tuberculosis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Lower Back Pain:<\/strong>\u00a0Pain in the lower back is one of the most common symptoms. The pain can be localized to the spine and worsen over time.<\/li>\n\n\n\n<li><strong>Spine Stiffness:<\/strong>\u00a0Stiffness of the spine may be present, limiting mobility and making movement painful.<\/li>\n\n\n\n<li><strong>Vertebral Compression Disorders:<\/strong>\u00a0Bone destruction resulting from infection can lead to vertebral compression disorders, where the vertebrae lose their normal height.<\/li>\n\n\n\n<li><strong>Spinal Deformities:<\/strong>\u00a0Untreated spinal tuberculosis can cause spinal deformities, such as kyphosis or scoliosis, giving the spine a curved appearance.<\/li>\n\n\n\n<li><strong>Fever:<\/strong>\u00a0Some patients may present with fever, often associated with a systemic inflammatory response to the infection.<\/li>\n\n\n\n<li><strong>Fatigue:<\/strong>\u00a0Fatigue can result from chronic infection and the body&#8217;s immune response.<\/li>\n\n\n\n<li><strong>Weight Loss:<\/strong>\u00a0Unexplained weight loss may occur, often due to malnutrition related to illness.<\/li>\n\n\n\n<li><strong>Neurological Symptoms:<\/strong>\u00a0In advanced cases, when the spine compresses nerve structures, neurological symptoms such as numbness, tingling, muscle weakness, and impaired bowel or bladder function may occur.<\/li>\n\n\n\n<li><strong>Paravertebral Abscesses:<\/strong>\u00a0The formation of paravertebral abscesses can cause painful swellings in the affected area.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-ce6bd157781788c4b6d266be196eb050\"><span class=\"ez-toc-section\" id=\"Types_of_tuberculous_lesions_in_the_spine\"><\/span>Types of tuberculous lesions in the spine<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Tuberculous lesions in the spine can present in different forms. Here are four common types of tuberculous lesions seen in the spine:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Granulomas and Tubercles:<\/strong>\u00a0Tubercles, also called tuberculous nodules, are small nodular lesions that form as a result of infection with Mycobacterium tuberculosis. These granulomas can develop in the vertebrae and cause bone destruction, eventually leading to spinal deformities.<\/li>\n\n\n\n<li><strong>Paravertebral Abscess:<\/strong>\u00a0Tuberculous infections in the spine can result in the formation of paravertebral abscesses. These abscesses are pockets of pus that form in the surrounding soft tissues, usually in response to bone infection. They can be seen on X-ray images.<\/li>\n\n\n\n<li><strong>Tuberculous Spondylodiscitis:<\/strong>\u00a0Tuberculous spondylodiscitis is an inflammation of the intervertebral discs and adjacent vertebrae. It can cause changes in the height of the intervertebral discs, vertebral compressions and angular deformities, contributing to kyphosis.<\/li>\n\n\n\n<li><strong>Spinal Fusion:<\/strong>\u00a0In advanced cases of untreated spinal tuberculosis, there may be fusion of the affected vertebrae. This fusion often results from the progressive destruction of bone tissue and scarring reaction, leading to loss of mobility in the spine.<\/li>\n<\/ol>\n\n\n\n<p>It is important to note that spinal tuberculosis can affect multiple vertebrae, leading to more extensive lesions and severe complications. Accurate diagnosis of tuberculous lesions in the spine usually requires advanced imaging tests such as magnetic resonance imaging (MRI) and, in some cases, biopsies to confirm the presence of Mycobacterium tuberculosis.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-83860c4e22258f8056ce0105f971686b\"><span class=\"ez-toc-section\" id=\"Predisposing_factors\"><\/span>Predisposing factors<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Malnutrition<\/li>\n\n\n\n<li>Poor sanitation<\/li>\n\n\n\n<li>Overcrowding<\/li>\n\n\n\n<li>Close contact with a tuberculosis patient<\/li>\n\n\n\n<li>Multiple pregnancy<\/li>\n\n\n\n<li>Immunodeficiency state<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-16ef48e7d095c72aa6be8b9398251756\"><span class=\"ez-toc-section\" id=\"Regional_distribution_of_spinal_tuberculosis\"><\/span>Regional distribution of spinal tuberculosis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Cervical \u2013 12%<\/li>\n\n\n\n<li>Cervicodorsal \u2013 5%<\/li>\n\n\n\n<li>Dorsal \u2013 42%<\/li>\n\n\n\n<li>Dorsolumbar \u2013 12%<\/li>\n\n\n\n<li>Lumbar \u2013 26%<\/li>\n\n\n\n<li>Lumbosacral \u2013 3%<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-e325219c33f84028df5aa23b007abefb\"><span class=\"ez-toc-section\" id=\"Radiographic_signs_of_spinal_tuberculosis\"><\/span>Radiographic signs of spinal tuberculosis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Tuberculosis of the spine, also called Pott&#8217;s disease when it affects the vertebrae, has specific radiographic findings. These findings may vary depending on the stage of the disease and the severity of the disease. Some of the commonly observed radiographic findings include:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Bone Lesions:<\/strong>\u00a0X-rays may reveal characteristic bone lesions, such as areas of bone destruction, geodes, bone sequestra, and sometimes changes in bone density.<\/li>\n\n\n\n<li><strong>Spinal Deformity:<\/strong>\u00a0A spinal deformity may be present, often manifesting as vertebral compressions or angular deformities. This can result in curvature of the spine, including kyphosis, sometimes giving the appearance of a &#8220;game hump.&#8221;<\/li>\n\n\n\n<li><strong>Widening of Intervertebral Spaces:<\/strong>\u00a0Infection can cause widening of the intervertebral spaces, resulting in increased separation between the affected vertebrae.<\/li>\n\n\n\n<li><strong>Abscess Formation:<\/strong>\u00a0Abscesses may form around infected vertebrae. These abscesses, sometimes called paravertebral abscesses, may be visible on X-rays as opaque areas.<\/li>\n\n\n\n<li><strong>Soft Tissue Reaction:<\/strong>\u00a0A reaction of the surrounding soft tissues, such as enlargement of the tissues, may be seen on X-rays. This may be due to inflammation and the immune response to the infection.<\/li>\n\n\n\n<li><strong>Spinal Fusion:<\/strong>\u00a0In some advanced cases, there may be fusion of the affected vertebrae, resulting in loss of mobility in the spine.<\/li>\n\n\n\n<li><strong>Intervertebral Disc Erosion:<\/strong>\u00a0Infection can cause erosion of the intervertebral disc, changing the height of the disc and contributing to spinal deformities.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading has-white-color has-midnight-gradient-background has-text-color has-background has-link-color wp-elements-191f28f862d2376da76d19ec639d3827\"><span class=\"ez-toc-section\" id=\"Reference\"><\/span>Reference<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Tuli SM. Historical aspects of Pott&#8217;s disease (spinal tuberculosis) management.\u00a0\u00a0Eur Spine J.\u00a0\u00a02013 Jun;\u00a022 Suppl 4\u00a0:529-38. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3691412\/\">PMC free article<\/a>\u00a0] [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22802129\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Dobson J. Percivall Pott.\u00a0\u00a0Ann R Coll Surg Engl.\u00a0\u00a01972 Jan;\u00a050\u00a0(1):54-65. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2388056\/\">PMC free article<\/a>\u00a0] [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/4550865\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Oettinger T, J\u00f8rgensen M, Ladefoged A, Hasl\u00f8v K, Andersen P. Development of the Mycobacterium bovis BCG vaccine: review of the historical and biochemical evidence for a genealogical tree.\u00a0\u00a0Tuber Lung Dis.\u00a0\u00a01999;\u00a079\u00a0(4):243-50. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10692993\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>McLain RF, Isada C. Spinal tuberculosis deserves a place on the radar screen.\u00a0\u00a0Cleve Clin J Med.\u00a0\u00a02004 Jul;\u00a071\u00a0(7):537-9, 543-9. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15320363\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Arockiaraj J, Karthik R, Michael JS, Amritanand R, David KS, Krishnan V, Sundararaj GD. &#8216;Need of the Hour&#8217;: Early Diagnosis and Management of Multidrug Resistant Tuberculosis of the Spine: An Analysis of 30 Patients from a \u201cHigh Multidrug Resistant Tuberculosis Burden\u201d Country.\u00a0\u00a0Asian Spine J.\u00a0\u00a02019 Apr;\u00a013\u00a0(2):265-271. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6454281\/\">PMC free article<\/a>\u00a0] [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30669824\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Rajasekaran S, Soundararajan DCR, Shetty AP, Kanna RM. Spinal Tuberculosis: Current Concepts.\u00a0\u00a0Global Spine J.\u00a0\u00a02018 Dec;\u00a08\u00a0(4 Suppl):96S-108S. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6295815\/\">PMC free article<\/a>\u00a0] [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/30574444\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Shetty AP, Viswanathan VK, Kanna RM, Shanmuganathan R. Tubercular spondylodiscitis in elderly is a more severe disease: a report of 66 consecutive patients.\u00a0\u00a0Eur Spine J.\u00a0\u00a02017 Dec;\u00a026\u00a0(12):3178-3186. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28593383\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Jain AK, Dhammi IK. Tuberculosis of the spine: a review.\u00a0\u00a0Clin Orthop Relat Res.\u00a0\u00a02007 Jul;\u00a0460\u00a0:39-49. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17438468\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Rasouli MR, Mirkoohi M, Vaccaro AR, Yarandi KK, Rahimi-Movaghar V. Spinal tuberculosis: diagnosis and management.\u00a0\u00a0Asian Spine J.\u00a0\u00a02012 Dec;\u00a06\u00a0(4):294-308. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3530707\/\">PMC free article<\/a>\u00a0] [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/23275816\">PubMed<\/a>\u00a0]<\/li>\n\n\n\n<li>Jain AK. Tuberculosis of spine: Research evidence to treatment guidelines.\u00a0\u00a0Indian J Orthop.\u00a0\u00a02016 Jan-Feb;\u00a050\u00a0(1):3-9. [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4759871\/\">PMC free article<\/a>\u00a0] [\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26955172\">PubMed<\/a>\u00a0]<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>The incidence of tuberculosis is increasing. The factors responsible are the increase in the number of immunocompromised persons, the development of drug-resistant strains of Mycobacterium tuberculosis and the aging of the population. HIV is the main risk factor for reactivation of latent TB infections. The World Health Organization estimates that one-third of the world&#8217;s population is infected with this organism and that it is the most common cause of death and disability in the world. Approximately one-fifth of newly diagnosed cases are extrapulmonary, and the spine is involved in 50% of cases of bone and joint TB.<\/p>\n","protected":false},"author":1,"featured_media":26245,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","iawp_total_views":4,"footnotes":""},"categories":[231,221,227],"tags":[],"class_list":{"0":"post-26217","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-lumbar-spine","8":"category-spine","9":"category-thoracic-spine"},"_links":{"self":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/26217","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/comments?post=26217"}],"version-history":[{"count":0,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/posts\/26217\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media\/26245"}],"wp:attachment":[{"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/media?parent=26217"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/categories?post=26217"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/osteomag.ca\/en\/wp-json\/wp\/v2\/tags?post=26217"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}