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Spinal tuberculosis (also called Pott’s disease) is an infection of the spine by the tuberculosis germ that usually starts in the lungs and then spreads to the spinal bones and nearby discs. Over time it can quietly damage the vertebrae, cause deformity, and sometimes press on the spinal cord or nerves.

1) What is this condition?

TB bacteria settle in the spine (most often mid‑ to low‑back), eating away at the bones and discs.
Typical signs include persistent back pain, stiffness, tiredness, weight loss, night sweats, and sometimes a soft swelling (“cold abscess”) near the spine.
As bone is destroyed, the spine can bend forward into a hump (kyphosis) and may compress the spinal cord.

2) How serious is it?

It is serious because it can quietly progress for months and, if untreated, may cause severe deformity and even paralysis or loss of bladder/bowel control.
With early diagnosis and full TB treatment, most people recover well and avoid major disability.

3) Non‑surgical treatments

Full‑course TB antibiotics (“anti‑TB chemotherapy”):
- Usually 6–12 months of a multi‑drug regimen (commonly isoniazid, rifampin, pyrazinamide, and ethambutol initially), tailored to local guidelines and drug resistance.
Close rest and spine protection early on; sometimes a brace is used to support the spine while the infection settles.
Good nutrition, treatment of other illnesses, and pain control to support healing and tolerance of long‑term medicines.
Structured rehabilitation (physical and occupational therapy) to preserve or restore movement, strength, and independence.

4) Types of surgery that may be necessary

Debridement and decompression: removing infected, dead bone and disc, and cleaning out abscesses that press on the spinal cord or nerves.
Reconstruction and stabilization:
- Rebuilding collapsed areas with bone graft or cages and fixing the spine with screws and rods from the front, back, or both.

5) Goals of surgery vs non‑surgical care

Non‑surgical goals:
- Eradicate the infection with antibiotics, relieve pain, and allow the spine to heal without major surgery whenever it is safe to do so.
- Prevent or limit deformity and nerve problems through bracing and rehab.
Surgery goals:
- Relieve pressure on the spinal cord and nerves, drain abscesses, correct or prevent severe deformity, and stabilize the spine.

6) How surgery can “fix” the problem

Debridement removes infected bone, discs, and pus pockets, reducing germ load and creating space around the spinal cord.
Decompression frees the spinal cord and nerves from mechanical pressure, helping pain, weakness, and numbness improve.
Stabilization with screws, rods, and bone graft holds the spine in a safer alignment while TB medicines work and the bone fuses.

7) Risks of surgery (general and specific)

General risks: infection (on top of existing TB), bleeding, blood clots, lung or heart complications, and anesthesia risks.
Spine‑specific:
- Nerve or spinal cord injury leading to new or worse weakness, numbness, or bladder/bowel issues.
- Hardware failure or non‑healing (non‑fusion), especially in very damaged or osteoporotic bone, sometimes needing further surgery.

8) Chances this surgery will work

Most people improve or stabilize neurologically when surgery is combined with full‑course TB treatment, especially if done before damage is extreme.
Reviews report that surgery plus antibiotics can give good pain relief, improved walking, and better correction of deformity in the majority of appropriately selected patients.

9) Possible complications from the surgery

Persistent or recurrent infection if TB treatment is incomplete, drug‑resistant, or adherence is poor.
Residual or worsening deformity, chronic pain, or neurologic deficits despite surgery, especially when treatment is delayed.
General surgical issues such as wound breakdown, deep infection, or need for revision stabilization.

10) Typical recovery from the condition

With full TB treatment alone, 80–95% of patients improve significantly, including pain relief and even some correction of deformity.
Neurologic recovery (if the cord was affected) can take many months; early treatment, incomplete paralysis, and good nutrition are linked to better outcomes.
Long courses of medicine can be tiring; rehab and psychosocial support are important for adherence and function.

11) Typical recovery after surgery

Hospitalization covers pain control, wound care, and early mobilization with a brace as needed.
TB antibiotics are continued for many months after surgery; rehab focuses on safe movement while protecting the repair and rebuilding strength.
Functional improvements (walking, self‑care) may continue for 6–24 months, especially when combined with strong rehab programs.

12) How long in the hospital

Uncomplicated cases treated medically may be managed mostly as outpatients, sometimes with a short initial stay for diagnosis and stabilization.
Surgical cases often stay 5–10 days or more, depending on the extent of surgery, nutrition, and other health problems, followed by inpatient or intensive outpatient rehab.

13) Long‑term outlook

With timely diagnosis and complete TB therapy, many patients achieve good pain control, solid fusion, and near‑normal function.
Worse outcomes are linked to long delays before treatment, severe malnutrition, drug‑resistant TB, multiple involved levels, and severe spinal cord damage.
A small percentage develop significant long‑term deformity or neurologic disability despite treatment.

14) Need for outpatient follow‑up

Regular follow‑up with infectious‑disease or TB specialists to monitor medication side effects, adjust regimens, and confirm completion of therapy.
Spine and rehab follow‑up with periodic imaging to check healing, alignment, and hardware (if present), and to guide bracing and exercise progression.
Long‑term monitoring for late deformity, recurrent TB, or lingering neurologic problems, with early re‑evaluation if new pain, weakness, or bladder/bowel changes develop.