- India remains one of the few countries worldwide where Tuberculosis is still plaguing the population
- Awareness about Spinal Tuberculosis is almost nil and treatment is not followed as required
Malti Devi was presented to Dr. Rahul Gupta, Additional Director, Department of Neurosurgery, Fortis Hospital, Noida in an almost paralysed condition. Severe pain in her back plagued her day to day life and she was barely able to move her limbs let alone walk. After conducting appropriate tests on his patient to confirm his suspicions, Dr. Gupta diagnosed that Malti Devi was suffering from Spinal Tuberculosis and required immediate, urgent surgical treatment.
Spinal Tuberculosis is a self-destructive form of TB and causes severe damage to the spine and consequently, even death if not treated in early stages. Spinal TB is a condition of disintegration of the spinal disk space and the most common symptoms are back pain, spinal tenderness, paralysis of the legs and lower body and spinal deformities. Magnetic resonance imaging (MRI) is a sensitive imaging technique that picks up images of disintegration of the spine that can take place almost immediately after contracting this disease. Neuroimaging-guided needle biopsy from the affected site in the center of the vertebral body is the gold standard technique for early and accurate diagnosis.
Dr. Rahul Gupta, Additional Director, Department of Neurosurgery, Fortis Hospital, Noida says, “TB is generally associated with lungs and throat. Very few understand that it can affect several other parts of the body. Bottom of FormWhen a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to every other part of the body, such as the kidney, spine, liver, scalp, bones and brain. TB is a communicable disease and can be passed on to others.”
India is the country with the highest burden of TB. The World Health Organization (WHO) TB statistics for India for 2016 gives an estimated incidence figure of 2.79 million cases of TB for India. It is estimated that about 40% of the Indian population is infected with TB bacteria, the vast majority of whom have latent TB rather than TB disease.
Dr. Rahul Gupta adds, “Diagnosis of the spinal TB at early stages is very important followed by prompt and adequate treatment that can completely cure spinal tuberculosis. Once the patient reaches the stage of paralysis the recovery may not always be possible despite surgical treatment. Medications have to be taken regularly and diligently over a period of 18 months. Signs of total recovery can be seen only after this.”
Malti Devi reveals, “We had gone to a local doctor who was able to assess my condition and recommended that we rush to Dr Rahul Gupta. I could not move even a little when I came under DrGupta’s care. From no mobility to being able to walk in a few weeks’ time is a blessing and, I thankDr Gupta’s expertise for that.”
Dr. Rahul Gupta adds, “While the Government has conducted an effective campaign for treatment and eradication of the TB of lungs which is known as DOTS, there is not enough information whether the government bodies are doing anything for eradication of spinal TB. It is known that the drugs for TB are being given free of cost by the government. Unfortunately, people are either not taking the drugs properly or misusing the drugs. This leads to what is known as resistant TB which is on a significant rise. MDR TB or multi drug resistance TB and XDR or extreme drug resistant TB is most dangerous as this can lead to death.”
TB is currently the world’s deadliest infectious disease, causing more annual deaths than HIV. India has the dubious distinction of being number one in the world for deaths from tuberculosis with 423,000 TB deaths in 2016. India is the highest TB burden country with WHO statistics for 2011 estimating incidence figure of 2.2 million cases of TB for India. This has risen to 2.79 million cases out of a global incidence of 9.6 million cases. The high mortality can be attributed to a delay in diagnosis and secondly, inadequate treatment, even after diagnosis. More steps to spread awareness about this disease should be taken by the government to reduce the burden of this disease on the young population.
Dr. Rahul Gupta signs off with facts, “Private hospitals see maybe one or two cases every month with spinal TB and one case every two months with brain TB. The doctors in government hospitals treat 5 -6 cases of spinal TB and similar numbers of brain TB every month. And those are numbers that are not coming down.”