Abstract
Tuberculosis remains endemic in the United States with an estimated incidence of 15.9 cases per 100,000 population. In North America and Saudi Arabia tuberculosis of the spine is primarily a disease of adults. In Saudi Arabia the average age on presentation is 41 years. Spinal tuberculosis begins classically in the anterior inferior portion of a vertebral body. The infection spreads beneath the anterior longitudinal ligament to involve adjacent vertebral bodies. Disc space narrowing is a secondary phenomenon, occurring when destruction of the cancellous bone permits herniation of the disc into the affected vertebral body. Initially the lesion is purely lytic, so that in the early phase bone scanning, both with technetium polyphosphate and gallium, is often negative. With combination chemotherapy virtually all patients are curable, but early treatment demands early diagnosis.
As the incidence of Pott disease has decreased so too has the medical awareness of this condition. Many physicians now believe it to have been totally eradicated. Particularly in the older age group, in whom other infections, tumours, and metabolic conditions are common, the differential diagnosis of a spinal lesion should include tuberculosis. The grossly destructive changes observed characteristically in children tend to develop only late in adults, making recognition of the early manifestations of the infection in the older patient much more important.
Similar content being viewed by others
References
Bailey H, Sister Mary Gabriel, Hodgson AR, Shin JS (1972) Tuberculosis of the spine in children. J Bone Joint Surg [Am] 54:1633
Chung SM, Kim NH, Kim YA, Kang ES, Park BM (1978) Clinical studies of tuberculosis of the spine. Yonsei Med J 19:96
Frankel ML, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH, Vernon JDS, Walsh JJ (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia, Part I. Paraplegia 7:172
Hodgson AR (1975) Infectious disease of the spine. In: Rothman RM, Simeone FA (eds) The spine. Saunders, Philadelphia
Keers RY (1978) Pulmonary tuberculosis — a journey down the centuries. Balliere Tindall, London
Kemp HBS, Jackson JW, Jeremiah JD, Cook J (1973) Anterior fusion of the spine for infective lesions in adults. J Bone Joint Surg [Br] 55:715
Kemp HBS, Jackson JW, Jeremiah JD, Hall AJ (1973) Pyogenic infections occurring primarily in intervertebral discs. J Bone Joint Surg [Br] 55:698
Leff A, Lester TW, Addington W (1979) Tuberculosis —a chemotherapeutic triumph but a persistent socioeconomic problem. Arch Intern Med 139:1375
Martin NS, (1970) Tuberculosis of the spine. J Bone Joint Surg [Br] 52:613
Medical Research Council, 1st Report: Seddon H Sir (Chairman), Fox W, Konstam PG, Scadding JG, Stott H, Sutherland I, Tall R, Griffiths DL (1973) A controlled trial of ambulant out-patient treatment and in-patient rest in bed in the management of tuberculosis of the spine in young Korean patients on standard chemotherapy. J Bone Joint Surg [Br] 55:678
Medical Research Council, 4th Report (1974) A controlled trial of anterior spinal fusion and debridement in the surgical management of the spine in patients on standard chemotherapy: a study in Hong Kong. Br J Surg 61:53
Medical Research Council Working party on Tuberculosis of the Spine, 7th Report (1978) A controlled trial of anterior spinal fusion and debridement in the surgical management of tuberculosis of the spine in patients on standard chemotherapy: a study in two centres in South Africa. Tubercle 59:79
Tuberculosis statistics (1977) State and cities DHEW publication (CDC) 79-8294 Atlanta US Department of Health, Education and Welfare, Public Health Service, Center of Disease Control
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Weaver, P., Lifeso, R.M. The radiological diagnosis of tuberculosis of the adult spine. Skeletal Radiol 12, 178–186 (1984). https://doi.org/10.1007/BF00361084
Issue Date:
DOI: https://doi.org/10.1007/BF00361084