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Diagnostic Modalities in TB Spine: Clinical Laboratory Diagnosis and Technological Advancements

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Tuberculosis of the Spine

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Abstract

Tuberculosis (TB) remains a major global health burden. There still remains a large gap between the notified and estimated incident cases. Extrapulmonary TB represents 15% of all TB cases, and the diagnosis is more challenging due to the paucity of the organism. Smear microscopy is often insensitive, and culture methods are prolonged.

Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. Characteristically, there is destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation.

The gold standard method of diagnosis of tuberculosis is the growth of Mycobacterium in culture specimens from the infected tissue and is considered the single most confirmatory diagnostic test for spinal TB. However, due to its very poor sensitivity, histopathological studies demonstrating classical granulomas and staining of smears to identify acid fast bacilli (AFB) are considered as reference standards for all other diagnostic modalities. Apart from indirect serological markers of inflammation, immunological tests have also been used with varied results. Molecular diagnostics are frequently being used because of its rapidity.

The engineering of antigens/antibody nanocarriers represents an exciting front in the field of diagnostics, potentially flagging the way toward development of better diagnostics for TB.

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Authors and Affiliations

  1. Department of Complex Spine Surgery, Salford Royal Hospital, Stott Lane, Salford, Lancashire, UK

    Rajat R. Verma

  2. Salford Royal Hospital NHS Foundation Trust, Salford, Lancashire, UK

    Shivan Marya

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  1. Rajat R. Verma
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  2. Shivan Marya
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Correspondence to Rajat R. Verma .

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Editors and Affiliations

  1. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India

    Sarvdeep Singh Dhatt

  2. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India

    Vishal Kumar

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Verma, R.R., Marya, S. (2022). Diagnostic Modalities in TB Spine: Clinical Laboratory Diagnosis and Technological Advancements. In: Dhatt, S.S., Kumar, V. (eds) Tuberculosis of the Spine. Springer, Singapore. https://doi.org/10.1007/978-981-16-9495-0_6

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  • DOI: https://doi.org/10.1007/978-981-16-9495-0_6

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