Spinal Tuberculosis: Rethinking an Old Disease

Catarino, Isabel; Lopes, Daniel; Sousa, Carlos de

doi:10.4172/2165-7939.1000358

Cited by 21 publications

(36 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, differential diagnosis is necessary for reinforcing the diagnostic value of the observed vertebral lesions. In addition to spinal TB, it includes pyogenic spondylitis, brucellar spondylitis, fungal spondylitis, and compression fractures (Aufderheide & Rodríguez‐Martín, ; Esteves et al, ; Garg & Somvanshi, ; Ortner, ; Pigrau‐Serrallach & Rodríguez‐Pardo, ; Rivas‐Garcia et al, ; Spiegel et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Today, skeletal tuberculosis (TB) occurs in 1–3% of TB patients and accounts for 10–35% of extrapulmonary TB cases (Garg & Somvanshi, ; Kumar, ; Pigrau‐Serrallach & Rodríguez‐Pardo, ; Vanhoenacker, Sanghvi, & De Backer, ). It is usually secondary to haematogenous spread of TB bacteria from a primary location outside the skeleton into the bone and/or synovial tissue (Esteves, Catarino, Lopes, & Sousa, ; Garg & Somvanshi, ; Spiegel, Singh, & Banskota, ). Any part of the skeleton can be affected by tuberculosis, but its most preferential skeletal localisation is the spine, followed by the hip and knee joints (Garg & Somvanshi, ; Vanhoenacker et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…The most common type of tuberculous spondylitis (90–95%) is the paradiscal form that arises from the anterior subchondral (paradiscal) region of the vertebral body (Esteves et al, ; Rivas‐Garcia, Sarria‐Estrada, Torrents‐Odin, Casas‐Gomila, & Franquet, ; Spiegel et al, ). The presence of TB bacteria triggers the formation of osteolytic lesions in the paradiscal area, with subsequent involvement of the entire vertebral body and occasionally of the posterior elements (Esteves et al, ; Rivas‐Garcia et al, ). Later, the infection may spread vertically beneath the anterior longitudinal ligament from the primarily affected vertebra into a similar location at one or more contiguous vertebrae or beyond (Aufderheide & Rodríguez‐Martín, ; Esteves et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…. It is usually secondary to haematogenous spread of TB bacteria from a primary location outside the skeleton into the bone and/or synovial tissue (Esteves, Catarino, Lopes, & Sousa, 2017;Garg & Somvanshi, 2011;Spiegel, Singh, & Banskota, 2005). Any part of the skeleton can be affected by tuberculosis, but its most preferential skeletal localisation is the spine, followed by the hip and knee joints (Garg & Somvanshi, 2011;Vanhoenacker et al, 2009).…”

mentioning

confidence: 99%

“…Although tuberculous spondylitis typically affects two or more contiguous vertebrae, multilevel noncontiguous (less than 10%) or solitary vertebral involvement can also occur in a few cases (Garg & Somvanshi, 2011;Kumar, 2005;Pigrau-Serrallach & Rodríguez-Pardo, 2013;Spiegel et al, 2005). Based on the location of tuberculous lesions in the vertebra, five main types of spinal TB can be distinguished: paradiscal, central, anterior subligamentous, posterior, and articular forms (Esteves et al, 2017;Garg & Somvanshi, 2011;Kumar, 2005;Sridhar & Krishnan, 2009).…”

mentioning

confidence: 99%

See 4 more Smart Citations

Rare manifestations of spinal tuberculosis in the Robert J. Terry Anatomical Skeletal Collection (National Museum of Natural History, Smithsonian Institution, Washington, DC, USA)

Spekker

Hunt

Váradi

et al. 2018

Intl J of Osteoarchaeology

View full text Add to dashboard Cite

Today, osteoarticular tuberculosis (TB) is a rare extrapulmonary manifestation of TB, developing in about 1–3% of patients. Although any part of the skeleton can be affected by tuberculosis, the spine represents the most common site of involvement (~50%). Spinal TB or tuberculous spondylitis typically affects 2 or more contiguous vertebrae, predominantly in the lower thoracic (40–50%) and upper lumbar (35–40%) regions. In the minority of patients (less than 10%), multilevel noncontiguous involvement occurs. By the location of lesions in the vertebra, 5 main types of spinal TB can be distinguished: paradiscal, central, anterior subligamentous, posterior, and articular forms, with the first being the most common type (90–95%). In the palaeopathological literature, the majority of the described spinal TB cases represent the paradiscal form affecting 2 or more contiguous vertebrae in the thoracolumbar region. The aim of our paper is to provide 3 example cases of known age at death, sex, and cause of death from the Terry Collection that show vertebral alterations indicative of rare manifestations of tuberculous spondylitis, and to interpret the observed lesions with regard to their diagnostic value in the palaeopathological practice. Terry No. 468 (23‐year‐old, male, died of pulmonary and spinal TB) exhibited bony changes presumably attributed to the anterior subligamentous form, whereas Terry No. 902 (c. 36‐year‐old, male, died of pulmonary TB) very likely represents the articular and anterior subligamentous types. The vertebral lesions recorded in the skeleton of Terry No. 1124R (49‐year‐old, female, died of pulmonary TB) are suggestive of the paradiscal form with multilevel noncontiguous involvement. Our paper provides palaeopathologists with a stronger basis for identifying tuberculosis in ancient human remains that reveal unusual vertebral alterations resembling that of our cases and, therefore, with a more sensitive means of assessing TB prevalence in past populations.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Rare manifestations of spinal tuberculosis in the Robert J. Terry Anatomical Skeletal Collection (National Museum of Natural History, Smithsonian Institution, Washington, DC, USA)

Spekker

Hunt

Váradi

et al. 2018

Intl J of Osteoarchaeology

View full text Add to dashboard Cite

show abstract

Spinal tuberculosis in Afghanistan: A 2019‐2020 study of patients in Kabul hospitals

Qaderi,

Mashid,

Gachkar

et al. 2023

Public Health Challenges

View full text Add to dashboard Cite

BackgroundTuberculosis (TB) is endemic in many low‐income countries, which can affect the spine in 1%–5% of those with an active infection. This study reports the clinical characteristics of patients admitted for spinal TB in Kabul, Afghanistan, a country with very limited resources.MethodsThis was a descriptive study among 26 patients treated for spinal TB in three major referral hospitals in Kabul, Afghanistan, between March 2019 and April 2020. The sociodemographic and clinical details, gender, age, site of infection, presenting complaints, signs, and symptoms of the patients were retrieved from their medical records. Summary statistics were analyzed using SPSS version 20. Ethics approval was obtained from the ethics committee of Shahid Beheshti University of Medical Sciences in Tehran, Iran.ResultsData were available for 26 patients with spinal TB admitted consecutively. The mean age of the sample was 38.2 years (SD 17.5), and there were 16 males and 10 females. Median time from symptom onset to hospital admission was 60 days. The most common diagnostic imaging technique used was magnetic resonance imaging (92.3%), followed by computed tomography (7.7%). The majority of the lesions involved the lumbar spine (61.4%), followed by the thoracolumbar spine (30.8%). Back pain was the most common manifestation in 21 patients (80.8%), and varying degrees of neurological impairment were found in 16 (61.5%) patients. There were no deaths among the patients up to the discharge date.ConclusionsThis study describes the clinical characteristics of spinal TB among patients in Kabul, Afghanistan. It is essential to strengthen preventive strategies and to improve health awareness about clinical features of spinal TB in patients with chronic back pain even in the absence of signs of TB.

show abstract