General and simple presentation of tuberculosis of spine on incidence, pathology, complications, management. This presentation is suitable for PGs, Ugs. spinal tuberculosis, potts spine, tb spine, caries spine, spine infection, kyphosis

1. Dr.A.Mohan krishna
M.S.Ortho., MCh Orth (U.K)
Consultant Orthopaedic surgeon,

2. 2

4. Hameatogenous
spread

10. Granuloma formation
Tissue necrosis &
inflammatory response
Paraspinal Abscess
LocalizedTrack along tissue
planes
Progressive necrosis of
vertebral body-Kyphotic
deformity
Adjacent vertebral
bodies under the
longitudinal ligaments
Along the fascial planes Ex:
Psoas abscess

17. Compressive
Early onset Paraplegia
ACTIVE With in 2 years
Late onset paraplegia
HEALED After 2 years
Tubercular granulation tissue,
Sequestra, abscess,
Caseous tissue
Stretching of cord,
Myelomalacia,
Internal gibbus,

19. Depends on
the severity of
involvement of
long tracts

21. Cold
abscess /
sinuses
Constitutional
symptoms: fever, wt
loss, night cries
(Children)
Back pain is earliest
& common
symptom
Weakness
paraplegia

26. > 50% of bone
destruction before
seen radiologically
Classic Radiological triad
Primary
Vertebral lesion
Disc space
narrowing
Paravertebral
abscess
Typical tubercular
spondylitic features in
long standing
paraspinal abscesses
Aneurysmal
phenomenon
Fusiform
paraspinal soft
tissue shadow
Skip
lesions
7-10%

29. CT or USG guided aspiration :
HPE / Microbiology / Culture

32. 3(HRZE) / 3(HRZS) + 3(HRZ)+12(HR)
Paediatric age group, streptomycin (for 2 months)
replaces ethambutol to avoid optic neuropathy
4(HRZE) + 14(HR)