Commonly, in tuberculous spondylitis, the symptoms develop insidiously due to the slow progression of the disease, contributing to a significant delay between symptoms onset and diagnosis.
The mean age of patients with tuberculous spondylitis is 45-60 years, although two peaks are reported concerning risk factors: one between 20 and 30 years, related to immigration and HIV, and one between 60 and 70 years, related to immunosuppression and comorbidities .
Spinal Tuberculosis, also called tuberculous spondylitis, makes 50% of the bony cases and 0.5-1.5% of all cases of tuberculosis.2,3 Clinical symptoms of tuberculous spondylitis i.e.
A combination of well defined paraspinal abnormal signal and a thin and smooth abscess wall is seen in 90% of tuberculous spondylitis and zero % in pyogenic spondylitis.
Jayaswal, "Outcome of minimally invasive surgery in the management of tuberculous spondylitis," Indian Journal of Orthopaedics, vol.
Bakalim, "Tuberculous spondylitis, a clinical study with special reference to the significance of spinal fusion and chemotherapy," Acta Orthopaedica Scandinavica.
Spinal osteotomy: correcting sagittal balance in tuberculous spondylitis. J Spinal Disord Tech 2008;21(7):484-8.
One-stage surgical management for multilevel tuberculous spondylitis of the upper thoracic region by anterior decompression, strut autografting, posterior instrumentation and fusion.
However, surgical intervention should be considered if a tuberculous spondylitis
is resistant to antibiotics, or neurological symptoms or spinal instability appears .
This compares to an ESR of 20-40 and greater than 40 mm/hr in 21.4 % and 73.2% cases in a study of 69 cases of tuberculous spondylitis
with diagnosis based on clinical, radiologic, histopathologic and AFB smear or culture at our center in Riyadh, Saudi Arabia.7
(8.) Jung et al, Discrimination of Tuberculous spondylitis
from Pyogenic spondylitis on MRI, AJR 2004: 182: 1405-1410.
Role of CT and MR imaging in the management of tuberculous spondylitis
. Radiol Clin North Am 1995; 33 (4): 787-804.