Delay in diagnosis of spinal TB lands many in paraplegia: Experts

On World Tuberculosis (TB) Day, city doctors have said that spinal TB could often be confused with arthritis and delay in diagnosis or treatment could lead to severe problems including paraplegia

On World Tuberculosis (TB) Day, city doctors have said that spinal TB could often be confused with arthritis and delay in diagnosis or treatment could lead to severe problems including paraplegia. Experts mentioned that it is important to understand that back pain cannot be only related to arthritis. Also, any form of severe back pain should be immediately consulted with a doctor.

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A 55-year-old woman who was affected by spinal tuberculosis that eventually led to a total loss of nerve sensations in her lower body was happy that she could walk again.

Requesting anonymity, she said, “Being able to walk again has been a moment of great joy. A delay in diagnosis landed me in total paraplegia, it has been three months since I was unable to walk. I was suffering from back pain for more than six months. Initially, I neglected it but after consulting many doctors and after a battery of tests I was diagnosed with spinal TB. Now, post-surgery, I can walk and free of back pain.”

Dr Shailesh Hadgaonkar, orthopaedic spine surgeon from Sancheti hospital who treated the woman said, “We get to see around twenty cases every month at our hospital. We get early, mid, and late-stage cases but not all cases require surgery. Surgery is only for those who cannot walk. In around 10 to 20 per cent of the newly diagnosed spinal TB cases paraplegia is seen. Even if a patient has developed paraplegia, there is always a good chance of recovery if treated early.”

Spinal TB is often misdiagnosed as arthritis, experts point out the need to spot correct symptoms. Spinal TB patients often lose weight and appetite, and they get excruciating pain even in deep sleep.

Dr. Hrushikesh Mehata, consultant orthopaedic spine surgeon from Noble Hospital said, “The most common form of TB affects lungs and is called ‘pulmonary TB’ but it may spread to other areas like spine which is then called as ‘extra-pulmonary TB’. TB infection can travel through blood from the lungs to reach the spinal column. This is more commonly seen in people wherein immunity is compromised due to any reason. Diagnosis of spinal tuberculosis is often delayed due to lack of specific symptoms. One must have a high index of suspicion and good clinical acumen to diagnose it early, any severe and prolonged back pain should be investigated and treated early.”

Dr Ajit Kulkarni, consultant pulmonologist at Sahyadri Hospitals said that delayed diagnosis of TB can affect lungs and other organs also. Spinal tuberculosis comes under the category of extra pulmonary TB. In India, the percentage of having extra pulmonary TB is the same as having pulmonary TB that is lung TB. Spinal TB is second in extra pulmonary TB as far as its prevalence is concerned. Many times, the diagnosis gets delayed because the symptom can be a simple backache which is neglected. It must be investigated properly with consultation of the doctor and early diagnosis is based CT and MRI of spine. While pulmonary TB may require six months of treatment, however, for spinal TB it requires 18 to 24 months of treatment.”

Dr. Reema Kashiva, another senior physician from the city said, “The functioning of all the vital organs in our body are interconnected. If any organ gets damaged the health of the entire body is affected. Just like Covid-19 which usually causes respiratory symptoms. However, it may cause fatal illness affecting many other body’s systems. In many cases it is seen that patients suffering from Covid-19 have died of cardiac injury. In some Covid-19 patients, nervous system damage has led to seizures and hallucination. Kidney damage was commonly seen in many Covid-19 patients. Like Covid-19, TB commonly affects the respiratory system. But TB also affects, abdomen, kidney, bone, and joint, and central nervous system. In all the life-threatening respiratory diseases, like tuberculosis, lung cancer, pulmonary embolism, and Covid-19, it is seen that if it is not treated early, it can damage other vital organs of the human body. Hence, early diagnosis and timely treatment is important to save other body organs.”