Diagnosis of spinal tuberculosis by any medical technique?

This article is professionally consulted by Master, Doctor Luu Thi Bich Ngoc - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital.

Tuberculosis of the spine is an infection caused by TB bacteria that invade the bones of the spine and/or lumbar discs. Previously, spinal tuberculosis was considered a dangerous disease because there was no effective treatment. Diagnosis of spinal tuberculosis if done early will bring good prognosis, minimize sequelae and improve quality of life. X-ray of the spine is the first-line imaging tool for the diagnosis of spinal tuberculosis.

The spine consists of many vertebrae, interspersed between the vertebrae are discs that help bend, bend and rotate movements easily. Spinal tuberculosis is a disease caused by tuberculosis bacteria, usually secondary to pulmonary tuberculosis. The vertebral body is the most damaged site because it contains many blood vessels, abundant oxygen, favorable for the growth of tuberculosis bacteria. The vertebrae are most affected, accounting for more than 90% of the thoracic vertebrae, in contrast, cervical tuberculosis is the rarest form. Accordingly, spinal tuberculosis is the most common form of bone and joint tuberculosis, accounting for about 65% of all cases.
Tuberculosis of the spine is a serious disease, which reduces the quality of life of patients, leaving many sequelae such as quadriplegia, disability, and even death. In the past, spinal tuberculosis was seen as a challenge, because there was no effective treatment. However, today with the development of medicine, tuberculosis of the spine is no longer a challenge in our country's medicine. Most cases can be effectively treated with spinal TB and make a full recovery.
Tuberculosis of the spine can appear at any age. In the past, more than half of spinal TB occurred in children. Over time, the age distribution of patients with spinal tuberculosis tends to shift to young adults over 20 years old and middle aged 40 to 50 years old. Men have a higher risk of vertebral tuberculosis than women.
SEE ALSO: How does tuberculosis of the spine form?

Tuberculosis of the spine progresses slowly, silently, often only detected when it has entered the advanced stages. Some clinical symptoms encountered by people with spinal tuberculosis are listed as follows:
Whole body fatigue, loss of appetite, weight loss Back pain, or at the damaged spine. Pain often appears dull, continuous, increasing in the evening and when moving. Pain in spinal tuberculosis is usually localized to the affected area. Patients with tuberculosis of the lumbar spine have to deal with more severe pain, which can spread to the buttocks and legs if there is compression of the lumbar nerve root. Muscle atrophy: Leg muscles are often atrophied due to nerve compression. This symptom can be unilateral or bilateral. When leg atrophy is due to spinal cord compression, symptoms tend to develop more slowly. Dry skin, hair loss, nails: is a manifestation of metabolic status, caused by nerve root compression. Paralysis: the patient can have paralysis of both legs or quadriplegia, depending on the location of spinal tuberculosis. This is a very serious complication that can lead to death. Inflammation, abscess: Tuberculous abscesses may appear secondary to spinal tuberculosis. The location of the abscesses is very variable, including at the damaged spine, abdominal, thigh, and neck abscesses... Some cases of spinal tuberculosis show abscesses that make patients can misdiagnosed as a common bacterial infection. Treatment in these situations is often ineffective because antibiotics are not specific for TB bacteria.

Spinal tuberculosis needs to be diagnosed early to increase the success rate of treatment. Diagnosis of spinal tuberculosis needs to be based on a lot of information, a combination of clinical examination, history taking and the use of paraclinical and imaging tools.
Basic tests to determine inflammation should be ordered from the beginning, including: Blood count test, CRP, erythrocyte sedimentation rate. Collect specimens from abscesses, pox exudate or destructive bone tissue to look for the presence of TB bacteria by culture technique, PCR. However, these tests are only supportive, the positive rate is low.
MORE: X-ray image of spinal tuberculosis
Imaging facilities play an important role in the diagnosis of spinal tuberculosis. X-ray of the spine is the first-line technique indicated because it is cheap and easy to perform, available at many medical facilities. Besides, computed tomography of the spine is also used to diagnose spinal tuberculosis with stronger X-ray intensity. The condition of vertebral destruction is the typical image of spinal tuberculosis on computed tomography film. Magnetic resonance imaging of the spine is a high-cost technique, which is advantageous in surveying soft tissue lesions, especially in spinal discs and abscesses in neighboring areas.
Tuberculosis of the spine is a dangerous disease and can leave severe sequelae. However, if detected and treated early, patients will have a better chance of treatment for a better quality of life.
Currently, Vinmec International General Hospital has been and continues to be fully equipped with modern diagnostic facilities such as: PET/CT, SPECT/CT, MRI, X-ray machine..., testing myelogram, histopathology, immunohistochemistry, genetic testing, molecular biology testing,... to diagnose spinal tuberculosis. The entire medical examination and treatment process at Vinmec is carried out by a team of highly qualified and experienced doctors, resulting in accurate diagnosis and better treatment opportunities. Therefore, customers who want to learn about spinal tuberculosis diagnosis techniques can go directly to Vinmec International General Hospital for service.