Spinal Tuberculosis

Abstract

Tuberculosis is one of the most common infectious diseases worldwide. The frequency in Germany is low, however, an increase has been observed in the past few years. The incidence of extrapulmonary manifestation accounts for up to 10 to 20%. In 50% of these cases the spinal column is affected. Although literature reveals worldwide experiences in the treatment, in Germany spinal tuberculosis remains a rarity. Different pitfalls and specific characteristics regarding diagnosis and therapy are to consider. Therefore, a presentation of these specifics and their discussion based on the available literature will be presented. The purpose is to achieve an increase in awareness regarding this, in our latitudes, rare disease.

Key words

tuberculosis - spine - diagnosis - therapy - special features

Publication History

Article published online:
21 January 2021

• References/Literatur

• 1 Suárez I, Funger SM, Kroger S. et al. The Diagnosis and Treatment of Tuberculosis. Dtsch Arztebl Int 2019; 116: 729-735
• 2 Trecarichi EM, Di Meco E, Mazzotta V. et al. Tuberculous spondylodiscitis: epidemiology, clinical features, treatment, and outcome. Eur Rev Med Pharmacol Sci 2012; 16 (Suppl. 02) S58-S72
• 3 Fuentes FM, Gutierrez TL, Ayala RO. et al. Tuberculosis of the spine. A systematic review of case series. Int Orthop 2012; 36: 221-231
• 4 Ali A, Musbahi O, White VLC. et al. Spinal Tuberculosis: A Literature Review. JBJS Rev 2019; 7: e9 doi:10.2106/JBJS.RVW.18.00035
• 5 Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med 2011; 34: 440-454
• 6 Kumar K. Spinal tuberculosis, natural history of disease, classifications and principles of management with historical perspective. Eur J Orthop Surg Traumatol 2016; 26: 551-558
• 7 Arbelaez A, Restrepo F, Castillo M. Spinal infections: clinical and imaging features. Top Magn Reson Imaging 2014; 23: 303-314
• 8 Khanna K, Sabharwal S. Spinal tuberculosis: a comprehensive review for the modern spine surgeon. Spine J 2019; 19: 1858-1870
• 9 Wang Y, Wang Q, Zhu R. et al. Trends of spinal tuberculosis research (1994–2015): A bibliometric study. Medicine (Baltimore) 2016; 95: e4923
• 10 Nickerson EK, Sinha R. Vertebral osteomyelitis in adults: an update. Br Med Bull 2016; 117: 121-138
• 11 Skaf GS, Kanafani ZA, Araj GF. et al. Non-pyogenic infections of the spine. Int J Antimicrob Agents 2010; 36: 99-105
• 12 Viswanathan VK, Subramanian S. Pott Disease (Tuberculous Spondylitis). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020. Online (last access: 15.10.2020): https://www.ncbi.nlm.nih.gov/books/NBK538331/
• 13 Kizilbash QF, Seaworth BJ. Multi-drug resistant tuberculous spondylitis: A review of the literature. Ann Thorac Med 2016; 11: 233-236
• 14 Kandwal P, Vijayaraghavan G, Jayaswal A. Management of Tuberculous Infection of the Spine. Asian Spine J 2016; 10: 792-800 doi:10.4184/asj.2016.10.4.792
• 15 Diehn FE. Imaging of spine infection. Radiol Clin North Am 2012; 50: 777-798
• 16 Rajasekaran S, Soundararajan DCR, Shetty AP. et al. Spinal Tuberculosis: Current Concepts. Global Spine J 2018; 8(4 Suppl.): 96S-108S
• 17 Zarghooni K, Röllinghoff M, Siewe J. et al. Spondylodiszitis – eine interdisziplinäre Herausforderung. Dtsch Med Wochenschr 2010; 135: 1182-1185
• 18 Colmenero JD, Jimenez-Mejias ME, Sanchez-Lora FJ. et al. Pyogenic, tuberculous, and brucellar vertebral osteomyelitis: a descriptive and comparative study of 219 cases. Ann Rheum Dis 1997; 56: 709-715
• 19 Dunn RN, Ben Husien M. Spinal tuberculosis: review of current management. Bone Joint J 2018; 100-B: 425-431
• 20 Peters KM, Jäger M. Tuberkulöse Spondylitis. Osteologie 2017; 26: 219-222
• 21 Leone A, DellʼAtti C, Magarelli N. et al. Imaging of spondylodiscitis. Eur Rev Med Pharmacol Sci 2012; 16 (Suppl. 02) S8-S19
• 22 Murray MR, Schroeder GD, Hsu WK. Granulomatous Vertebral Osteomyelitis: An Update. J Am Acad Orthop Surg 2015; 23: 529-538
• 23 Thurnher MM, Olatunji OR. Infections of the spine and spinal cord. Handb Clin Neurol 2016; 136: 717-731
• 24 Esendagli-Yilmaz G, Uluoglu O. Pathologic basis of pyogenic, nonpyogenic, and other spondylitis and discitis. Neuroimaging Clin N Am 2015; 25: 159-161
• 25 Heyde C-E. Die bakterielle unspezifische „pyogene“ Spondylodiszitis. Osteologie 2017; 26: 211-218
• 26 Louw QA, Tawa N, Van Niekerk SM. et al. Spinal tuberculosis: A systematic review of case studies and development of an evidence-based clinical guidance tool for early detection. J Eval Clin Pract 2020; 26: 1370-1382 doi:10.1111/jep.13309
• 27 Sharma A, Chhabra HS, Chabra T. et al. Demographics of tuberculosis of spine and factors affecting neurological improvement in patients suffering from tuberculosis of spine: a retrospective analysis of 312 cases. Spinal Cord 2017; 55: 59-63
• 28 Erlemann R. Spondylitis und ihre Differenzialdiagnosen. Orthopädie und Unfallchirurgie up2date 2013; 8: 331-351
• 29 Prodi E, Grassi R, Iacobellis F. et al. Imaging in Spondylodiskitis. Magn Reson Imaging Clin N Am 2016; 24: 581-600
• 30 World Health Organization. Treatment of Tuberculosis: Guidelines for national Programmes. 4th ed. 2010. WHO/HTM/TB/2009.420. Accessed December 14, 2020 at: https://apps.who.int/iris/bitstream/handle/10665/44165/9789241547833_eng.pdf;jsessionid=C983B53C6309C701BFE0B95720967328?sequence=1
• 31 Nene A, Bhojraj S. Results of nonsurgical treatment of thoracic spinal tuberculosis in adults. Spine J 2005; 5: 79-84
• 32 Panchmatia JR, Lenke LG, Molloy S. et al. Review article: Surgical approaches for correction of post-tubercular kyphosis. J Orthop Surg (Hong Kong) 2015; 23: 391-394
• 33 Jutte PC, van Loenhout-Rooyackers JH. Routine surgery in addition to chemotherapy for treating spinal tuberculosis. Cochrane Database Syst Rev 2006; (05) CD004532
• 34 Schaberg T, Hauer B, Loddenkemper R. et al. [Recommendations for personal respiratory protection in tuberculosis]. Pneumologie 2004; 58: 92-102