Researching on a large relevant literature of spinal tuberculosis, this paper discussed characteristics of spinal tuberculosis and its early diagnosis method. If spinal tuberculosis can be found and treated earlier, prognosis will be better. The early diagnosis of spinal tuberculosis has become hot spot at present. There are many different diagnostic methods including clinical manifestation, laboratory examination, imaging examination, etc. The newest standpoint showed that immunization has closely correlation with tuberculosis and it will become the focus and developmental direction of future research in spinal tuberculosis. In addition, we should know the differential diagnosis of spinal tuberculosis to avoid the misdiagnosis.
Diagnosis, Differential ; Early Diagnosis ; Humans ; Tuberculosis, Spinal ; diagnosis

Spinal tuberculosis is curable disease, and early diagnosis is mandatory for early treatment. We reviewedconventional radiographies and CT from Histopathologically confirmed 30 cases of spinal tuberculosis, and comparedthese findings with radiologic findings from 2 cases of pyogenic spondylitis and 4 cases of meastasis. The resultswere as follows: 1. The frequnet site of involvement were thoracolumbar juntion and low lumbar vertebrae, and themost frequent type is multisegmented subligamentous type (93.3%). 2. CT was not of great use in the diferentaldiagnosis of the tuberculosis. Dominant CT findings of tuberculous spondylitis were anterior vertebral bodydestruction, paravertebral soft-tissue mass and thick walled abscess formation occasionally containingcalcification and disc space narrowing, in the setting of an indolent or relatively benign course. 3. CT is thebest modality for imaging the extent and anatomy of the destructive process, the degree of canal encroachment, andthe change of adjacent vital structure. So CT was particularily useful in pre-operative planing of debridement andstabilization surgery. 4. The most common causes of neurologic manifestations in tuberculous spondylitis were thecompression of spinal cord by sequestrated bony fragments and disc material, granulation tissue or abscess in thespinal canal.
Abscess ; Debridement ; Early Diagnosis ; Granulation Tissue ; Lumbar Vertebrae ; Neurologic Manifestations ; Spinal Cord ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

The spinal column is involved in less than 1% of all cases of tuberculosis (TB). Spinal TB is a very dangerous type of skeletal TB as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity. Therefore, early diagnosis and management of spinal TB has special importance in preventing these serious complications. In order to extract current trends in diagnosis and medical or surgical treatment of spinal TB we performed a narrative review with analysis of all the articles available for us which were published between 1990 and 2011. Althoug h the development of more accurate imaging modalities such as magnetic resonance imaging and advanced surgical techniques have made the early diagnosis and management of spinal TB much easier, these are still very challenging topics. In this review we aim to discuss the diagnosis and management of spinal TB based on studies with acceptable design, clearly explained results and justifiable conclusions.
Congenital Abnormalities ; Early Diagnosis ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Spine ; Tuberculosis ; Tuberculosis, Spinal

The progression of spinal tuberculosis is usually slow and insidious, and its main symptom, backache, is nonspecific. Considerable delay in diagnosis may occur before an infectious process is considered. Even when a diagnosis of spinal tuberculosis is considered, it may be difficult to confirm. Radiological findings indicative of tuberculosis are involvement of the vertebral bodies on either side of the disc, subligamentous spread, abscess formation and collection and expansion of granulation tissue adjacent to the vertebral body, relative sparing of the disc space and calcification within a paravertebral abscess. We report two patients with spinal tuberculosis who had nonspecific backache and received a delayed diagnosis for several months or years.
Abscess ; Back Pain ; Delayed Diagnosis ; Granulation Tissue ; Humans ; Tuberculosis ; Tuberculosis, Spinal

STUDY DESIGN: A review of related literatures of diagnosis and treatment of spinal tuberculosis. OBJECTIVES: The aim of the study was to discuss treatment strategies by understanding of emerging problems related to spinal tuberculosis. SUMMARY OF LITERATURE REVIEW: Owing to modern diagnostic modalities, development of prevention and chemotherapy, the incidences of tuberculosis infection including spinal tuberculosishave been decreasing. Moreover, these medical these improvements of medical and surgical treatments the improvement of surgical techniques for spinal tuberculosis reduced the incidence of kyphosis or neurologic complications such as Pott's paralysis. MATERIALS AND METHODS: Review of related literatures. RESULTS: Recently,the occurrence of multi-drug resistant strain, an increasing number of opportunistic infections and an atypical presentation in spinal tuberculosis are emerging as new challenges. CONCLUSIONS: An appropriate diagnosis and surgical interventions are our obligation as clinicians dealing with this unique infectious disease to minimize the complications for the treatment of spinal tuberculosis.
Communicable Diseases ; Diagnosis ; Drug Therapy ; Incidence ; Kyphosis ; Opportunistic Infections ; Paralysis ; Spine* ; Tuberculosis* ; Tuberculosis, Spinal

The classical Roentgenographic features of tuberculosis of the spine such as narrowing of the intervertebraldisc, collapse of the vertebral bodies, with or without the shadow of a cold abscess, present a specific pictureof the actural pathological process. However, the diagnosis of tuberculosis is not confirmed unless proven bybiopsy, or the finding of the tubercle bacillus. 120 cases of proven spinal tuberculosis, at Kwangju ChristianHospital during the period form Jan 1973 through Aug. 1980, were studied and analysed. The results were asfollows; 1. The ratio of male to female was 1:1.1. The age preference was under 30 years old. 2. The most frequentsite of involvement was the lumbar spine(44.1%) and next the thoracic(39.2%0. 3. The incidence of lytic type was50.8%, mixed type 36.7%, and sclerotic type 12.5%. 4. Associated pulmonary tuberculous lesions were observed in 94patients (78.3%). 5. The central type, with wedging or collapse of the vertebral body, was more common in theyounger age group and the intrevertebral articular type in older patients. 6. The incidences of typical radiologicfindings were : Collapse of vertebral body(90%), cold abscess (78.3%) and narrowing of intervertebral space(70%).7. Associated kyphosis was observed in 37 cases (30.8%). Among these 37 cases the range of angulation was between21 to 40 degrees in 40%.
Abscess ; Bacillus ; Diagnosis ; Female ; Gwangju ; Humans ; Incidence ; Kyphosis ; Male ; Spine ; Tuberculosis ; Tuberculosis, Spinal

Tuberculosis remains high incidental disease in Korea with an estimated incidence of 2.5% in generalpopulation. Among the tuberculosis of bone, spinal tuberculosis is high incidence and curable disease, but earlytreatment demands early diagnosis. Authors reviewed clinical aspects of 376 cases, and reviewed conventional filmsof 74 cases and CT of 8 cases, confirmed histopathologically as spinal tuberculosis from Jan. 1976 to May 1985 atYonsei medical center, Yonsei University. The results were as follows: 1. The frequent site of involvement werelower thoracic and lumbar vertebra, 4th lumbar vertebra was the most common lesion site among them. 2. Theseperated lesions were 10.2% among spinal lesion. 3. The most common type and pattern of bone density wasintervertebral type and mixed pattern each other. 4. Paravertebral abscess, kyphosis and narrowing ofintervertebral disc space were discovered more than 80% in reviewed conventional films. 5. In children, there isno predilection site. 6. Spinal CT was more accurate diagnostic method than conventional study in the evaluationof following aspects: 1) extent of lesion 2) degree of spinal canal involvement 3) changes of surrounding organ.
Abscess ; Bone Density ; Child ; Early Diagnosis ; Humans ; Incidence ; Korea ; Kyphosis ; Methods ; Spinal Canal ; Spine ; Tuberculosis ; Tuberculosis, Spinal

PURPOSE: To assess the characteristic features of MR imaging in the diagnosis of spinal tuberculosis. MATERIALS AND METHODS: We retrospectively reviewed MR imaging of 27 cases with pathologically-proven spinal tuberculosis and analyzed the MR findings including the extent of the lesions on non-contrast T1, proton density, and T2*VI, and the specific contrast enhancement patterns of the lesion on Gd-DTPA enhnced TIWI. RESULTS: The inflammatory lesions showed low signal intensity on T1WI in 25 patients(93%) and high signal intensity on T2*gradient echo image in 25 patients(93%). Bone destruction was noted in 15 patients(55%), disc-space narrowing in 21 patients(77%), paravertebral abscess in 16 patients(59%), subligamentous extension in 23 patients(85%), kyphosis in 8 patients(29%), and spinal canal narrowing in 19 patients(70%). After Gd-DTPA was administrated, rim-enhancement was noted in all patients(100%). CONCLUSION: We conclude that MR imaging is an excellent imaging modality for establishing the diagnosis of spinal tuberculosis as well as delineating the extent of soft tissue involvement. Characteristic peripheral rim enhancement after injection of Gd-DTPA may provide rather specific diagnosis in spinal tuberculosis.
Abscess ; Diagnosis ; Gadolinium DTPA ; Kyphosis ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies ; Spinal Canal ; Tuberculosis, Spinal*

Child ; Humans ; Tuberculosis, Spinal/diagnosis* ; Spondylitis/diagnosis* ; Thoracic Vertebrae ; Suppuration/diagnosis* ; Diagnostic Errors

Tuberculous spondylitis is a very rare disease, but it can result in bone destruction, kyphotic deformity, spinal instability, and neurologic complications unless early diagnosis and proper management are done. Because the most common symptom of tuberculous spondylitis is back pain, it can often be misdiagnosed. Atypical tuberculous spondylitis can be presented as a metastatic cancer or a primary vertebral tumor. We must make a differential diagnosis through adequate biopsy. A 30-year-old man visited our clinic due to back and chest pain after a recent traffic accident. About 1 year ago, he had successfully recovered from tuberculous pleurisy after taking anti-tuberculosis medication. We performed epidural and intercostal blocks but the pain was not relieved. For the further evaluation, several imaging and laboratory tests were done. Finally, we confirmed tuberculous spondylitis diagnosis with the biopsy results.
Accidents, Traffic ; Adult ; Back Pain ; Biopsy ; Chest Pain ; Diagnosis, Differential ; Early Diagnosis ; Humans ; Rare Diseases ; Spondylitis ; Tuberculosis, Spinal ; Tuberculosis, Pleural