Tuberculosis (TB) is most commonly known as a lung disease. But the bones can be affected, too, a condition called osseous or skeletal TB. The number of people with TB has increased in the last 10 years. HIV positive patients have the highest incidence of skeletal TB now.
The authors of this study suspected spinal TB might be present at more than one spinal level. And they suggested there might be multiple skip lesions. In other words, the vertebrae aren’t all affected in a row. There might be one or two vertebrae with TB then one or more unaffected vertebrae before another vertebrae is diseased.
They suggested routine whole spine MRI would show the true incidence of this problem. To test out this theory, they did had whole spine MRIs on all patients with acute spinal infections. The study was carried out for five years.
Nearly three-fourths of the patients tested (71.4 per cent) were positive for multiple level spinal TB. Many of the patients had no symptoms at the additional sites of disease.
The results of this study were dramatic. Previous reports of multiple level spinal TB suggested a one to 10 per cent incidence. Using whole body MRI shows that the problem is much greater than previously thought. Any part of the spine can be affected.
The authors suggest whole body MRI for all patients suspected of having a spine infection. Early detection is the key to reducing other problems cause by this infection.