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    Spondilitis TB

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    Fidesha Nurganiah Siregar
    Spondylitis tuberculosis is a vertebral infection caused by Mycobacterium tuberculosis that most commonly affects the thoracic spine. It presents with non-specific symptoms like back pain, fever, and weight loss. Diagnosis involves blood tests, imaging studies like MRI, biopsy, and culture. Treatment consists of a prolonged course of anti-tuberculosis medications. Surgery may be needed for debridement or correction of deformity.

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    Spondilitis TB

    Uploaded by

    Fidesha Nurganiah Siregar
    149 views18 pages
    Spondylitis tuberculosis is a vertebral infection caused by Mycobacterium tuberculosis that most commonly affects the thoracic spine. It presents with non-specific symptoms like back pain, fever, and weight loss. Diagnosis involves blood tests, imaging studies like MRI, biopsy, and culture. Treatment consists of a prolonged course of anti-tuberculosis medications. Surgery may be needed for debridement or correction of deformity.

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    Spondylitis tuberculosis is a vertebral infection caused by Mycobacterium tuberculosis that most commonly affects the thoracic spine. It presents with non-specific symptoms like back pain, fever, and weight loss. Diagnosis involves blood tests, imaging studies like MRI, biopsy, and culture. Treatment consists of a prolonged course of anti-tuberculosis medications. Surgery may be needed for debridement or correction of deformity.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    149 views18 pages

    Spondilitis TB

    Uploaded by

    Fidesha Nurganiah Siregar
    Spondylitis tuberculosis is a vertebral infection caused by Mycobacterium tuberculosis that most commonly affects the thoracic spine. It presents with non-specific symptoms like back pain, fever, and weight loss. Diagnosis involves blood tests, imaging studies like MRI, biopsy, and culture. Treatment consists of a prolonged course of anti-tuberculosis medications. Surgery may be needed for debridement or correction of deformity.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 18

    SPONDYLITIS TUBERCULOSIS

    By :
    UMMU SAIDAH BAHRI
    C111 12 312

    Mentor :
    dr. William Limoa & dr. Ricky Tambunan & dr. Moh Asri Abidin

    Supervisor :
    dr. Jainal Arifin SP,OT (K) Spine

    DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNHAS 2018


    VERTEBRAL ANATOMY
    DEFINITION

     Vertebral infection caused


    by Mycobacterium
    Tuberculosis.

    Lewandrowski, Uwe K, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    EPIDEMIOLOGY
    O Incident
    increasing incidence of TB due to increasing immunocompromised population
    O Demografic
    HIV positive population (CD4+ count of 50 to 200)
    O Location
    15% of patients with TB will have extrapulmonary involvement
    The spine, and specifically, the thoracic spine is the most common
    extrapulmonary site
    5% of all TB patients have spine involvement

    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.
    ETIOLOGI

     Spondilitys TB caused by
    Mycbacterium Tuberculosis .
     Tb may occur from
    hematogenous spread from
    the primary focus of
    infection outside the spine

    Lewandrowski, Uwe K, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    Infection of the spine result from:
    Hematogenous PATHOGENESIS
    Limfogen
    Direct extension disease

    Bone destruction & caseosa


    necrosis

    abscess forming and granulomatous at the bottom spinal cord compresion


    of the anterior longitudinal ligament and periosteum

    Herkowitz Harry N, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    CLASSIFICATION

     3 Types of spondilitys TB :
    a. Paradiscal Type
    b. Central Type
    c. Anterior Type

    Lewandrowski, Uwe K, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    CLINICAL MANIFESTATIONS

    Signs and Symptoms:


    Fever
    Malaise
    Night Sweats
    Weight loss
    Back pain

    Lewandrowski, Uwe K, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.
    CLINICAL MANIFESTATIONS

    Physical examination :
     kyphotic deformity (gibbus )
     Neurological deficit
     Tenderrness

    Herkowitz Harry N, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders

    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.
    DIAGNOSTIC EVALUATION

     Count blood cell


    o relative lymphocytosis
    o low hemoglobin

     PPD (purified protein derivative of tuberculin)

    Lewandrowski, Uwe K, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.
    DIAGNOSTIC EVALUATION

    The acid-fast
    bacilli smear Spinal biopsy
    technique

    Culture Sputum
    specimens/
    gastric washings

    Herkowitz Harry N, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    DIAGNOSTIC EVALUATION

    Plain radiographs
     Peridiscal involvement, disc
    space narrowing followed by
    bone destruction.

    Herkowitz Harry N, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    DIAGNOSTIC EVALUATION

    CT SCAN

     Indications :
    • lesions <1.5cm (better
    than radiographs)
    • inaccurate for defining
    epidural extension

    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.
    DIAGNOSTIC EVALUATION
    MRI
    1. low signal on T1-weighted
    images, bright signal on T2-
    weighted images
    2. presence of a septate pre-/
    paravertebral / intra-osseous
    smooth walled abscess with a
    subligamentous extension and
    breaching of the epidural
    space
    3. end-plate disruption
    4. Paravertebral soft tissue shadow
    5. high signal intensity of the disc on the T2weighted image

    Lewandrowski, Uwe K, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.
    DIFFERENTIAL DIAGNOSIS

     Piogenic infections
     Vertebral Tumors

    Herkowitz Harry N, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    1. Agents
    Isoniazid (H), Rifampin (R), Ethambutol (E) and
    Pyrazinamid (Z)
    2. Regimen
    RHZE for 2 months, then RH for 9 to 18 months

    Lewandrowski, Uwe K, et al. 2011. Rothman-Simeone The Spine Sixth Edition, United States of America : Elsevier Saunders
    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.
    Anterior decompression, bone Pedicle subtraction
    grafting, anterior plating osteotomy

    Woon Coliin, 2015. Spinal Tuberculosis. https://www.orthobullets.com/spine/2027/spinal-tuberculosis. Diakses pada 28 juli 2018.

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