Tuberculous Spondylitit Wheeless

Description: 4000 cases of extrapulmonary involvment each year in the US;
- most common extra pulmonary location of TB is the spine;
- spine is the extrapulmonary site in over 50% of the cases of bone and joint involvement;
- about 2/3 of patients will have abnormal chest x-rays;
- severe kyphosis, sinus formation, & (Pott's) paraplegia are all late sequelae;
- sites of involvement:
- thoracolumbar spine is most common site of involvement (50% of patients);
- cervical spine and lumber spine are each involved in 25% of patients;
- pelvis, femur, and tibia may each be involved in 10% of patients;
- clinical features:
- neurologic deficit is uncommon in children;
- spinal cord injury may occur secondary to direct pressure from abscess, bony sequestra (good prognosis);
- most common presenting symptom is back pain, but systemic signs, such as fever, night sweats, anorexia, and weight loss, are common;
- associated injuries:
- probably more significant is the fact that any patient with spinal TB has 50% chance of having associated pulmonary, renal, or other viceral TB in their past medical history;