Modern View about Diagnosis of Spinal Tuberculosis

Abstract

Tuberculosis (from the Latin tuberculum - tubercle) is an infectious disease caused by Mycobacterium tuberculosis [1, 16]. The problem of tuberculosis remains relevant, since most often (62.2%) people of working age from 18 to 44 years old suffer from tuberculosis [6, 132, 150]. For every 100 newly diagnosed patients, there are 6 patients with HIV infection [74]. Mortality among such patients is 2 times higher than mortality from all other causes among patients with active tuberculosis and averages 22.6% [46, 62]. Damage to the spine due to tuberculosis has been known since ancient times; mention of this disease is found in Hippocrates and Galen [1, 94, 135]. According to Galinskaya L.A. et al . (2013), numerous historical documents and medical research materials indicate the widespread distribution of this form of osteoarticular tuberculosis in the distant past. According to the observations of specialists, the first place in terms of localization of the lesion is the thoracic (60%) and the second is the lumbar (30%) spine. The cervical (5%) and sacral (5%) parts of the spine are affected to a lesser extent [9, 33, 46, 156]. It is worth noting that in adults, double and triple localization of lesions were previously rare; now their frequency is about 10%. The number of affected vertebral bodies varies widely. Damage to 2-3 vertebral bodies in newly diagnosed patients is most often detected (in 65% of cases), destruction of one vertebral body is detected in 1-3% of cases [1, 108, 99]. Many authors are of the opinion that the diagnosis of “tuberculous spondylitis” is based, first of all, on establishing the fact of contact with a patient with tuberculosis, the presence of trauma and other predisposing factors [6, 107]. However, the leading role in the diagnosis of bone destructive changes in tuberculous lesions of the spine is played by radiation examination methods [81, 92]