Do you sometimes get back pain? Maybe it will subside in a few days. However, if this back pain persists, and if you also feel lethargic and have no appetite, it may not be a simple matter. Today we are going to talk about a spine-related disease that is a bit serious, but can be cured if treated properly. That is Pott's Disease, or Spinal Tuberculosis.
What is Pott's Disease?
Simply put, Pott's Disease is a bacterial infection that affects the bones in your spine, called the vertebrae . It's actually a type of tuberculosis (TB). But it's not limited to the lungs, it's a type of extrapulmonary TB . Think about it, it starts in the lungs first, then it moves to the spine.
This can cause long-term back pain , muscle weakness in the arms and legs, and if not treated properly, it can lead to spinal curvature and damage to the vertebrae. In some cases, this can be life-threatening.
Doctors may call this Pott's spine or tuberculosis spondylitis .
How common is Potts disease?
Potts' disease is one of the most common types of bone tuberculosis. Worldwide, it is estimated that about 10.6 million people were diagnosed with tuberculosis in 2022 alone.
What are the symptoms of Potts disease?
Now let's see what the symptoms of Pott's Disease are.
- Back pain: This is the main symptom.
- Neck pain: Sometimes pain can also occur in the neck.
- Arm and leg weakness: Feels like a lifeless state.
- Loss of appetite
- Unexplained weight loss
- Fever
It can affect any bone in the spine, that is, any vertebra. Often, more than one vertebra is affected. The places where you are most likely to feel these symptoms are:
- Cervical spine
- Thoracic or dorsal spine
- Lumbar spine
How does this happen?
Potts' disease is caused by a bacterium called Mycobacterium tuberculosis . When you breathe in tiny droplets from someone with tuberculosis, such as when they cough or talk, it first enters your lungs. Then, the infection spreads through your bloodstream to the bones in your spine.
Is this contagious?
Now you may be wondering, is this TB disease contagious? No, TB disease is not spread directly from person to person. TB is spread when it is in the lungs. That is, by germs that are released into the air when someone infected coughs or talks. By the time this infection spreads to the spine, it has completely left the lungs.
Who is most at risk?
Who is most likely to develop Potts disease?
- For those who have close contact with someone who has tuberculosis.
- For those who live in high population density areas.
- For those who cannot easily access health services.
Also, people with certain health conditions are at higher risk. For example:
- For those with malnutrition .
- For those addicted to drug use (Substance use disorder).
- For people with conditions that compromise your immune system , such as HIV .
What happens if treatment is not given? (Complications)
What happens if this is not treated properly? It can be really dangerous. Potts disease can damage the bones in your spine. This bacteria causes inflammation and pus-filled abscesses inside the spine. This inflammation and abscesses cause the bones in the spine to become compressed, weakened, and damaged. The vertebrae can break or even collapse. This can cause the spine to become unstable. This can lead to a forward bending (kyphosis), which is a condition where the spine curves forward, making it look like someone is hunched over.
Not only that, but other complications can occur:
- Difficulty standing and walking.
- Nerve compression: This can cause weakness in the limbs, numbness, and inability to control urine or stool.
- Paralysis may also occur.
- The infection can also spread to other parts of the body (for example, the brain, kidneys).
If the disease is recognized early and treatment begins, complications like these can be largely prevented.
How do you recognize this?
How do doctors diagnose Potts disease? After a doctor examines you and asks about your symptoms, they will do a few more tests. These tests are used to rule out other diseases with similar symptoms and confirm that it is spinal TB.
- Tuberculosis skin test: A small test done on the skin.
- Blood tests to detect tuberculosis bacteria.
- Imaging tests: For example, a spinal X-ray , an MRI (Magnetic Resonance Imaging) test, a CT (Computed Tomography) scan, or a PET (Positron Emission Tomography) scan.
Because the symptoms of Potts' disease are similar to those of several other common diseases, and because spinal TB is rare, it can sometimes be difficult to diagnose. Also, people living in areas with high TB rates but poor healthcare facilities may delay seeking treatment until complications develop.
What are the treatments?
Potts disease is treated in several stages. There are medications that must be taken for several months.
Can it be cured with medicine?
Your doctor may recommend chemotherapy medications such as:
- Isoniazid, Rifampicin, Pyrazinamide, Ethambutol and/or Streptomycin for about two months.
- After that, Isoniazid and Rifampicin may be taken for another four to twelve months, or maybe even longer.
It is very important to use this medication exactly as your doctor tells you. Stopping the medication before the prescribed time can reduce the effectiveness of the treatment.
Sometimes, the first-line drugs for TB don't work. This is called drug-resistant TB . If this happens, your doctor may recommend other medications, such as:
- Kanamycin
- Capreomycin
- Pyrazinamide
- Amikacin
- Fluoroquinolone
These drugs for drug-resistant tuberculosis can cause side effects. Your doctor will tell you about these.
Maybe surgery is needed?
Sometimes, surgery may be needed to repair your spine, reduce symptoms, and prevent complications of Potts disease. There are several types of surgery that can be performed:
- Debridement: Cleaning or removing damaged tissue around the spine.
- Drainage: The removal or draining of pus-filled abscesses that have accumulated in the spine.
- Stabilization and alignment: Tuberculosis can cause damage to the vertebrae. A surgeon may remove and/or repair broken bones and discs , and insert plates and screws to hold the bones in place.
- Fusion: A surgeon can permanently join two vertebrae together, limiting their movement and preventing pain and other complications. This may involve using a bone graft from another part of your body.
How is the recovery rate?
If diagnosed early and treated early, the chances of recovery from Potts disease are very good. It is said that about 95% of people who develop Potts disease and receive treatment in the early stages recover .
However, if spinal tuberculosis becomes severe, or if it does not respond to treatment and causes damage to the spine, it can be life-threatening. Your doctor will assess your chances of recovery based on your age, the response of your immune system, and your general health.
Potts disease can be cured with medication, but a cure is not always possible, especially if the tuberculosis is a drug-resistant strain.
Does Potts disease shorten life expectancy?
Your life expectancy after having Potts disease can vary greatly. If the disease is diagnosed and treated early, it probably won't affect your life expectancy. However, for young children, adults over 65, and people with weakened immune systems, the outcome of Potts disease can be generally worse, and can even be life-threatening.
Your doctor can best tell you about your life expectancy, including these facts:
- Your age and general health.
- The time you started treatment.
- The severity of the infection.
- You have complications.
- Whether or not your body is resistant to tuberculosis drugs.
Are there any ways to avoid this?
Because it is a type of tuberculosis infection, it is not possible to completely prevent Potts disease. However, you can do the following to reduce your risk of developing a tuberculosis infection:
- Avoid prolonged, close contact with someone who has an active TB infection.
- If you are at high risk of developing tuberculosis, or if you live in an area where the infection is common, get tested for tuberculosis regularly.
When should I see a doctor?
A tuberculosis infection first starts in the lungs (pulmonary TB). Pott's syndrome symptoms usually appear after the infection has spread from the lungs to the spine. See a doctor if you have any of these symptoms:
- A cough that lasts more than two weeks.
- Chest pain.
- If you cough up blood.
- Extreme fatigue.
- Muscle weakness.
- The food is tasteless.
- If you have a fever and chills.
You may not have any lung symptoms, but you may have tuberculosis. So if you have any symptoms of spinal tuberculosis, tell a doctor right away.
What questions should you ask the doctor?
When you see a doctor, you can ask these questions:
- Do I have Potts disease, or some other condition that affects my spine?
- What treatments do you recommend?
- When should I take medicine for tuberculosis and for how long?
- Are there any side effects from the medication?
- Will I need surgery?
The most important things you need to remember
Pott's disease can be a very challenging infection. Symptoms can make it difficult for you to sit comfortably, move your limbs, and live without pain. Treatment can take months to years to completely clear the infection from your body. You may even need surgery to repair your spine. All of this can leave you feeling overwhelmed and unable to participate in normal activities with your loved ones until you recover. But remember, you are not alone. A doctor can help you manage Potts disease, help you get better, and prevent life-threatening complications.
` Potts disease, spinal tuberculosis, back pain, tuberculosis, TB, spine, vertebrae
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