How to Recover from Spinal Cord Disease?

Clinical Features and Management of Spinal Cord Disease:

In developing countries, spinal TB is mostly a disease of childhood or adolescence. It usually affects the middle aged and is particularly prevalent in immigrant populations and in the immunocompromised. The incidence is now increasing, probably due to the development of antibiotic resistance.

The lower thoracic spine is commonly involved and the disease initially affects the intravertebral disc and spreads to adjacent vertebral bodies.

Clinical Features:

• The classic systemic features of weight loss, night fever and cachexia are often absent.
• Pain occurs over the affected area and is made worse by weight bearing.
• Symptoms and signs of cord compression occur in approximately 20% of cases.
• The onset may be gradual as pus, caseous material or granulation tissue accumulate, or sudden as vertebral bodies collapse and a kyphosis develops.

Straight X-rays are characteristics

• Anterior superior or inferior angle of the vertebral body is initially involved.
• Infective process spreads throughout the vertebral body and may involve the pedicles or facet joints.
• The disc space collapses as the vertebral plate is destroyed.

MRI with gadolinium shows an epidural mass with paraspinal soft tissue swelling.

Management:

Every effort is made to establish the diagnosis. A needle biopsy is often sufficient, but occasionally an exploratory operation (costotransversectomy) is required. Long-term antituberculous therapy is commenced.

If signs of cord compression develop, decompression is necessary.

• A Posterior Decompression, removing the remaining unaffected bone, is likely to cause instability an anterior or posterolateral approach is therefore required.
• Posterolateral Approach (costotransversectomy): One or more ribs are resected medially, along with the transverse processes.
• Anterior Transthoracic Decompression with strut graft fusion is something performed. This permits clearance of pus and caseous debris without retracting the spinal cord.

Braner Clinics is a professional corporation, and was established for the practice of chronic pain management in 1990. For best treatment of Spinal Cord Disease call now for Quick Appointment: (703) 573-1282