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pott's spine
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pott's spine

My son,aged 27,is under ATT forthe last 4 months as he has diagnosed with infection/ganulation formation at L5-S1.The pain has reduced to a great extent.Now,he is on R-cinex 600 and mycobutol 1200. Please suggest if any he can do any exercise for the back.Any other suggestion for speedy recovery.The period for which medication is likely to continue may also be advised.
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Avatar_n_tn
Hi Surjit,
How is your son? What have the doctor said? Pott's disease often involves two or more adjacent vertebral bodies.
What level is the spinal cord affected?
It is more common for lower thoracic and upper lumbar vertebrae to be affected in adults.
I don't think it is a nice idea to go for exercise when you are having Pott’s disease.
I think he should be completely the course of treatment and get a repeat imaging done to evaluate the spine.
Was there an abcess (abscess) formation? If yes, was it aspirated and sent for culture?
What did the doctor say about the source of infection?
What method has he planned for follow up? Was a culture being taken? If so, was it positive?
New smear or culture positive cases, the duration of treatment is 6 months which includes 2 months of intensive therapy and 4 months of continuation phase.
I would be interested to know about his disease progression and treatment.
Bye.
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357139_tn?1220104712
Respected Sir,
                     Thanx for your kind response.
The investigation of MRI Lumbo-sacral spine revealed as under:
       '"Signal alteration and enhanement of L5 & S1 vertebrae and part of posterior arch,sacral ala and pre,para sacral and right paraspinal muscle collection with extra-dural granulation tissue and right neural foramina collection at L5-S1 level.Findings are suggestive of pott'''s spine."'
          The following medicines were given for the first 3 months:
R-cinex 600
Mycobutol 1200
PZA 1500
           The PZA has been discontinued after 3 months.Now,R-cinex 600 & mycobutol 1200 is being given.
            The pain is cured,but when the sitting is of longer  duration,slight pain is felt .
The abcess (abscess)/lump has disappeared.No,culture was taken out.
            Further.valuable consultation is solicited.


              
  
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Avatar_n_tn
Hi Surjit,
This confirms the diagnosis of Pott’s spine and also that it is at lower back (area where it is common in adults).
Pain after sitting for longer duration may be due nerve compression.
How long they want to continue R-cinex and Mycobutol?
Is your son also on Vitamin B6 supplements?
You need to do a repeat a scan to see healing at the lower back.
Keep me informed.
Bye.
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357139_tn?1220104712
Respected Doctor,
                         A bundle of thanx for your quick and solicited response.
A second MRI was done after 2 months from the start of ATT which reads as under:
:           "Folllow-up case of caries spine showing signal alteration in body and right transverse process of L5 vertibra, S1 vertebral body and right sacral ala along with mild pre/right paraspinal soft tissue showing extension into right erector spinae muscles & overlying subcutaneous tissue. Mild soft tissue/granulation issue is noted in right neural foramen and right lateral recess at L5-S1 level with mild impression on right traversing nerve route. Comparison with previous MRI dated 18-08-2007 shows improvement and significant reduction in pre/right paraspinal soft tissue."

It is pertinent yo mention that second MRI is dated 30/10/2007.
-The medication i.e R-cinex & Mycobutol is likely to be continued upto the period of 6 months from the start of ATT.
-Vitamin  B6 supplements are also being given.
             Please advise if the pain can be attributed to resistance of the present medicine regime as one of the consultant has recommended to substitute Mycobutol 1200 with Oflox 800.
   Your valuable advice & guidance  is further solicited.

With Regards,
surjit singh

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Avatar_n_tn
Hi Surjit,
I have not heard of back pain being attributed to resistance to Mycobutol.
The common side effects of Ethambutol (active ingredient of Mycobutol) are visual disturbance, color blindness, skin rash, fever, confusion, headache, nausea, loss of appetite, abdominal pain, vomiting.
If a MRI which was done in 30/10/2007 shows improvement, where is the evidence of resistance of drugs?
How is his weight gain? Is he feeling feverish again? Does he have similar back pain what he used to have earlier? Is he not interested in taking his meals?
I think we should be doing a repeat MRI scan to assess amount of granulation tissue present.
Keep me informed.
Bye.
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357139_tn?1220104712
Resoected Doctor,
                          Thanx for your kind response.
My son has  gained weight about 4-5 kg during the period of medication.He has no fever.He now does not feel  morbid  pain as he felt earlier .  He has no loss of appetite and takes his meals regularly.However,recently he was having feeling of headache,nausea & vomiting.But after taking metrogyl 400 (twice a day for 5 days ) & domstar as well as Siazole tablets,he is feeling better.He is taking Liv52 since the begining of the treatment.
      Please advise if it is the right time to repeat MRI scan or we should wait for some more time.Further,please advise if  Vitamins B6 supplements have any side effects.
         With Regards,
surjit singh
            
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Avatar_n_tn
Hi Surjit,
I feel if there is any consensus of changing the medicines it should be done after looking at the current MRI scan as this was basis to start treatment and also basis to say that he was doing well.
You need to discuss this with your son's physician and decide regarding further management.
As far as Vitamin B6 supplements are concerned they are supposed to be continued.
Increase in dosage of Vitamin B6 can also cause headaches, nausea and vomiting.
I think his treatment is going on fine and we can wait and see for any new symptom development.
Keep me informed about the decision of treating doctor.
Bye.
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357139_tn?1220104712
Dear Doctor,
                 Please advise the B6 supplements which do not have animal extact/rennet and are useful in treatment of pott's spine.Also,please clarify if increase uric acid level can also attribute to ocassional pain in the lower back at L5-S1.Can uric acid be controlled without medicines?Is it true that anti -tuber drugs elevate the uric acid level.
                Is it advisable for the patient to resort to morning and evening walks? can light/yogic exercises meant for spine be undertaken?
                 Any other remedial/preventive measures may kindly be advised.
               With Regards,
                surjit singh
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Avatar_n_tn
Hi Surjit,
I am sorry to say that I am not aware of any vitamin B6 supplement free of animal extract.
Uric acid elevation can be due to renal failure or any medications which has decreased renal clearance.
High protein and weight reduction diet can also cause high uric acid.
Hyperuricemia can present with pain, but mostly in joints.
Yes he can do early morning and evening walks.
He can also try yoga and light exercises.
Keep me informed.
Bye.
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Avatar_m_tn
Hello Doctor,

My father, aged 62 yrs has been a diabetic for 12 years now. Last month, we visited an orthopedic surgeon since my father was complaining of back pain for about 3-4 months. On getting an x-ray, doctor suspected Spinal TB and recommended MRI. The MRI report confirmed Pott's Spine. Here's the extract of the MRI report:

Findings: The study shows marginal erosions of D8, D9 and D10 verteberal bodies involving D9-D10  intervening disc abd anterior aspect of D8-9 disc with pre, para and epidural multi loculated abscess collection. The right para verteberal collection measures 7.9x2.2 cms and left para vertebral collection mesures 6.3x2.6 cms. The epidural collection at D8-9 and D9-10 causin moderatte impression on thecal sac and bilateral lateral nerve roots. There is also altered signal intensity of D9 and D10 pedicles.

There is erosion with enhancement of anterior aspect of D11 and S1 vertebral bodies with minimal adjacent anterior vertebral collectoins.

Intervertebral Discs: Disc dehydration is seen at all levels.
L4-5 : Posterior central and bilateral para central disc protrusion causing mild impression and thecal sac, bilateral pre foraminal exiting and foraminal traversing nerve roots.

IMPRESSION: MR features are suggestive of KOCH's involving multiple Dorso-Lumbar vertebral and D8-D9, D9-10 discs as described with pre, para and epidural multi loculated abscess collection at D8,D9, and D10 levels causing significant impression on thecal sac and bilateral nerve roots.

The doctor adviced following medication:
AKT 4. (a pack with 4 diff tabs, 1 in the morn, 2 a\n and 1 in the night)
Myoril for 7 days
Taylors Brace

Doctor was contemplating a surgery and after discussioin with the neuro surgeon, they decided against the surgery since my father was mobile and there was no pain or trouble in walking and started the ATT and mentioned that after 4-6 weeks, a second scan would be required to see the development and then take a call on Surgery.

Its has been close to 4 weeks now since he is on ATT and since last 2 weeks, he gets sudden attack of severe back pain in the night. On 3 instances we had to rush to casualty in the middle of the night and get a pain releiving injection (Inj INAC).

We visted the doc and he said tht the we had manage the pain with pain killers for the time being and wait to complete 4 weeks of medication, to see any developments. He is also mentioning that surgery can be done if we are in agreement.

Now we are worried about whether to go for surgery or continue the ATT medication especially due to the fact that the pain is severe when it occurs and wanted a second opinion.

- Is such frequent sudden attack of pain common during such a treatment? Because the pain is frequent and severe, I was wondering if the medication was correct.

- I heard spinal surgery is only the last resort and that surgery is required on critical conditions when the patient becomes immobile. Is it true? In that case, should we consider not opting for surgery considering, there is no immobility?

Please advice, and sorry for such a extended discription of the whole situation. Just wanted to make sure I have given all the possible information.

Thanks and regards
Ranga
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Avatar_n_tn
Hi,
How is your father?
I am feeling bad for your father as he has to go thru all this at this age.
Tuberculosis (TB) of the spine (Pott’s disease) is the most common site of bone infection in TB; hips and knees are also often affected.  The lower thoracic and upper lumbar vertebrae are the areas of the spine most often affected.  
Drug treatment is generally sufficient for Pott’s disease, with spinal immobilization if required.  Surgery is required if there is spinal deformity or neurological signs of spinal cord compression.
The doctor is right in suggesting waiting for 4 weeks of medication, and a second scan would give a clear picture regarding surgery.
Yes, it is true that surgery is required on critical conditions.
Keep me informed.
Good luck.
Bye.
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Avatar_m_tn
Dear Doctor,

Thank you for such a quick response.

Just some more clarifications:

1. AKT 4 : I have heard from other people that they were adviced to take all 4 tabs in the strip together in the morning on empty stomach...however, we were adviced to take the red capsule in the morn, the 2 tabs in a\n and the other in the night. Is that the right way of dosage?

2. What could be cause of this sudden attack of pain? Is it common? My father was adviced of complete rest along with the taylors brace and he exactly doing that. With the start of medication, we were hoping the pain would reduce, but the pain is more sever than the past. Is pain killers the only solution for the time being?

Thanks again!

Regards
Ranga
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Avatar_n_tn
Hi,
I think the doctor is right in giving the drug in split dosages, but I have usually seen patient taking one in morning and others in afternoon before lunch.
The cause of sudden pain is due to reaction between the antibiotics and the organism at the back. This is causing pain and this will subside soon.
The pain will subside subsequently don't worry about it.
Keep me informed if you have any queries.
Bye.
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Avatar_m_tn
Thanks great information!

Thank you so much. I really appreciate your help!

Could you please tell me where you are located?

Thanks and regards
Ranga

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Avatar_n_tn
Hi Ranga,
How is your father feeling?
I really feel nice that I could help you out and most of your doubts are cleared.
I am based in India and you too seem to sound like an Indian.
Which city are you from and which doctor are you consulting?
I am physician with specialization in child health too.
I would be interested to answer question on child health and dental.
Keep me informed if you have any queries.
Bye.
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Avatar_m_tn
Hello Doctor,

I am from Bangalore and I am consulting Dr. HemaChandra Shetty (Orthopedic Surgeon) from Bangalore Hospital.

Where are you located in India? Do you pratice in a clinic or in a hospital?

Regards
Ranga

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Avatar_n_tn
Hi,
Currently I am based in Mumbai.
I have my clinic at Mumbai and attached to hospitals.
What about you, what are you basically?
Is there any body in family with history of chronic cough or any features of Tuberculosis?
How many family members are there in family? Any kid is there in family?
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Avatar_m_tn
Hi,

I work for Hewlett Packard as an Asst Mgr.

I have 2 elder sisters who are married. So currently at home, its just my parents and I..

My eldest sis has a 5 yr old son...she was in UK during her early pregnancy and duing that time she was diagonised with Pulmonary TB..other than that no history of TB in the family...my father had dry cough for a long time before spinal TB was detected..now tht has stopped...

Regards
Ranga
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Avatar_n_tn
Hi Ranga,
The reason I asked you about number of family members as every member of family should be screened for TB including the maid who comes to work.
If any kid is around then you should be screening that kid for TB.
Have you got yourself checked for TB?
Bye.
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Avatar_m_tn
Hello Doctor

No, None of us have got ourselves screened for TB? Hows can Spinal TB be contegeous??...You are scaring me :(

Regards
Ranga
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Avatar_n_tn
Hi Ranga,
I am sorry if you feel that I am scarring you. My intentions are clear to make sure that nobody else is affected.
You had mentioned earlier in one of your post that he is being having chronic cough for long.
If that's the case, you should be screening everybody in house.
I think the best way to do is to get you an x-ray chest done with tuberculin test.
Let me know where you are getting it done and what are the results.
If a newborn is around, then the baby needs to be started on ATT.
Bye.
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Avatar_m_tn
Hi,

Yes, he was having dry cough for while..that has stopped now...I will get myself screened for TB...Thanks for that info!

Regards\
Ranga
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Avatar_m_tn
Hi,

Yes, he was having dry cough for while..that has stopped now...I will get myself screened for TB...Thanks for that info!

Regards\
Ranga
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Avatar_n_tn
Hi Ranga,

How are you? As a doctor it is our nature to inform patients regarding disease and its manifestations. I thought it was my duty to inform you about screening as TB is curable and preventable disease. The medicines nowadays have much less side effects than before.
Keep me informed if you have any other queries.
Bye.
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Avatar_m_tn
Hi Doctor,

Thanks so much! I totally understand where you are coming from. Its great to see such personalised care. I have informed so many people about this website and the wonderful information we can get. Thanks again Doctor, for all your advice. I truely appreciate it!

Could I get your name please?

Regards
Ranga
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Avatar_n_tn
Hi,
My name is Dr. Kalpesh. Jain and I am a physician who is also a specialist in Child health.
You had mentioned you are Asst. Manager in HP, in what division?
Thanks for your kind reference and if I can be of any help for them, ask them to directly address to me.
Thanks.
Bye.
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Avatar_m_tn
Hi Dr.Kalpesh

I work for HP's financial operations in Bangalore..its part of HP's BPO..how do we address directly to you? Do you mean your email id? If so, what is it?

Regards
Ranga
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Avatar_n_tn
Hi,
You can address by my screen name on this forum.
Kalpesh.
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Avatar_m_tn
Hi Dr. Kalpesh

He had another attack of severe pain in the night yesterday and we went to the emergency center in the hospital and he got a shot of Inj. Inac..and slowly the pain subsided...this is the 4th time it happened like this in the last 2 weeks..he however does not have any problems in the legs, he is able to walk well....

Alos, for last 2 days he has also been complaining of uneasiness in the abdomen mainly because he has not been able to pass stools. Is this because of the medicines he is taking? Do you suggest any medication for no stools for 2 days....Please advice.

Thanks
Ranga
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Avatar_n_tn
Hi Ranga,
I am sorry to say but this pain due to flaring up of inflammatory response is due to medications. I didnt get what injection you are referring to, is it a painkiller or is it a steroid injection given at the site of pain?
Yes indeed it is because of the medicatons causing abdominal discomfort.
Yes I think he can take cremaffinn syrup 10ml just before going to bad. If constipation does not get he can increase the dose of cremaffin.
Keep me informed if you have any queries.
Bye.
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Avatar_m_tn
Hi Dr. Kalpesh

Inj INAC - its was a painkiller.

Thanks for your advice. When you say that the pain is due to infammatory response due to medication. Could it be possible that the infection is increasing? PLease let me know.

Thanks and regards
Ranga
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Avatar_n_tn
Hi,
When I say the pain is due to inflammatory response due to medication, it does not indicate that infection is increasing.
The inflammatory products due to reaction between antibiotics and the organisms initially cause pain, which will subsequently subside.
Keep me informed if you have any queries.
Bye.
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Avatar_m_tn
Thanks for the information!!

Regards
Ranga
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Avatar_m_tn
Hello Dr. Kalpesh

Cremaffin Syp did help, I bought the syrp and my father took 2 tsp of it before going to bed and he could pass stools the next day morning and now he is feeling ok.

Thank you!


Ranga
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Avatar_n_tn
Hi Ranga,
Cremaffin Syp contains Magenesium Hydroxide and Liquid Paraffin.
Magnesium hydroxide helps as an antacid, helps in nearly complete emptying of bowel and smaller doses might have milder laxative action.
Happy Republic Day.
Bye.
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Avatar_m_tn
Hi Dr Kalpesh

Thank you!

He had another attack of severe pain last night...its becoming more frequent now and I am worried.....the painkilling injection they gave him was Inj. INAC

Regards
Ranga
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Avatar_n_tn
Hi Ranga,
How long it’s been that doctors have started ATT on your father?
I think it is time now for you to check it with your father's primary consultant to check for causes of lower back pain.
I think he should be getting evaluated by an orthopaedician to evaluate for causes of lower back pain at this age.
In the lumbosacral spine, radicular symptoms are caused by an intervertebral disc bulge, protrusion, extrusion, or sequestration that compresses and inflames a nerve root in approximately 98% of all cases. Other causes of radicular symptoms emanating from the lumbosacral spine include disc osteophytes, a buckled ligamentum flavum, zygapophysial (Z)-joint hypertrophy, and other causes of lumbosacral spinal stenosis.
I recommend you to get his lower back imaging study done which includes an MRI study.
Keep me informed.
Bye.
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Avatar_n_tn
Hi Ranga,
How is your father doing?
Is he fine? Did he have repeated back pain?
Have you seen any orthopaedician and if yes, what they have to say about this?
Any imaging study is done?
I think the cause for his lower back pain could be his pathology of spinal disc.
Keep me informed.
Bye.
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Avatar_m_tn
Hello Dr Kalpesh

My father continously kept getting pain in the back more frequently, we went to Ortho Surg yest and after getting an x-ray, he said tht the abscess has not reduced and tht now there is a compression at T-7 and hence he has posted him for surgery for tomorrow at 1 PM. He also started feeling weakness in his legs, they are however still responding.....

My cousin who is also an Ortho Surg in Calicut (Kerala) came all the way to give a second opinion and he confirm the need for a surgery. Apparently it is a high risk surgery so I am just keeping my fingers crossed, however the Ortho and Neuro Surgeon have said tht the surgery should go well....I hope things go well by gods grace!!

Thanks for your follow up, I will keep you posted.

Regards
Ranga
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Avatar_n_tn
Hi,
I feel sorry that your father who is so old has to go through all this.
If there is indeed a need for surgery then it should be done. I think by the time you receive this post the surgery would be over.
Keep me posted as how the surgery was and whether the doctor's have send abcess (abscess) for culture and sensitivity.
The sample should be sent for AFB culture and if growth is found then it should be tested against the current regimen of ATT what your father is taking.
Keep me posted.
Bye.
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Avatar_m_tn
Hello Doctor,

Thanks for your reply.The surgery went well and all the abscess has been decompressed. I was told that the rib had to be cut at 2 places inorder to drain the abscess and a bone graft was put. T7 was partially compressed..

I am unaware of any culture been sent, is this to confirm if the current ATT is the right medication for treating the infection?

Please let me know

Thanks
Ranga
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Avatar_n_tn
Hi,
It is good to hear that surgery has gone well.
The key for draining abcess (abscess) was also to do culture and sensitivity and find out whether the current medications are sensitive to organism growing i.e. tubercular germs.
I think you should be cross checking with the doctor whether it is been sent. I am sure any doctor would send it to confirm the diagnosis and also to see for appropriate Anti-tubercular drugs.
Which hospital is the surgery conducted?
Keep me posted.
Bye.
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Avatar_m_tn
Hi Dr Kalpesh

Thanks for the information. The surgery was conducted in The Bangalore Hospital and the OrthoSurgeon is Dr. Hemachandra Shetty and the neuro surgeon is Dr. B.N. Muralidhar.

Thanks
Ranga
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Avatar_n_tn
Hi,
How are you feeling now that surgery has gone normal?
What did Dr. Hemachandra has to say about your father’s recovery?
What ATT's are continued for him?
Bangalore hospital is a good hospital with good success in surgeries.
Keep me posted.
Bye.
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357139_tn?1220104712
Respected Doctor,
                             This has reference to your last communication dt 14/01/08.
My son is better now,He was feeling no pain for the last 10 days.But recently,after he tried some exercises of spine,he is feeling mild pain off and on but not continuosly.Though he is no linger doing the said exercises,but the pain has not gone out.
                              He is still on ATT .Can you enlighten on this score.Please advise what measures may be taken for elimination of pain.Is it advisable to switch over to second line of drug as one of the consultant had advised to take oflin400(twice a day)instead of mycobutol1200.
with profound regards,
surjit singh
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Avatar_n_tn
Hi,
It's great that your son is doing well. How many months have passed since he is on ATT?
Are we continuing the first line of ATT or have we changed in between the treatment?
Mild pain of spine while doing back exercises is expected but the pain should not be annoying. If pain is annoying then we need to start him on analgesics.
He can be started on pain killers like paracetamol, Ibuprofen or tramadolol. This you need to take upon prescription from the doctor.
I am not sure why some doctor has advised your son to take second line of ATT.
Has your son gained weight after the treatment has been started?
Keep me posted with your answers.
Bye.
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357139_tn?1220104712
Respected Doctor,
                         Thanx for prompt response..
My son is on ATT since 24/08/2007 and he is continuing with the first line of ATT since then.He gained weight about 6-7 kg after the treatment was started.Though,the doctor had prescribed Iugesic for relief from pain,but he is not taking it as the pain is not so annoying.However, he has to give 8 to 10 hours while sitting on computer,which also attributes to uneasiness in the lower back.
with Regards,
surjit singh
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Avatar_n_tn
Hi,
As he doing well with first line of drug I would not like to change any medication. Why is the decision taken to change the antibiotic? What rationale has been applied for that?
Who asked to change the medication whether it is the first doctor or you have approached any new doctor?
He can take Ibugesic if he feels pain.
Keep me posted with your answers.
Bye.
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357139_tn?1220104712
Respected Doctor,
                         It was the second doctor who prescribed the change in medicine.It was perhaps due the fact that the pain has not gone completely.However,the first doctor is of the view that we should continue with the first line as hitherto as it is responding progress in treatment.
                          Since the pain is not so annoying,Ibugesic is being avoided for the time being.
                           Please advise when we should go for another MRI to evaluate the progress in treatment.
                   thanx.
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Avatar_n_tn
Hi,
I feel your son should continue with first line of ATT as that has shown improvement in his signs and symptoms. I would not recommend you to change his antibiotics. You can ask your son to take Ibugesic as when required.
Can you tell me when was the last MRI done and what duration his treatment plan?
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357139_tn?1220104712
Respected Doctor,
                          The disease was diagnosed through MRI dt.18/08/07.Thereafter another MRI was taken out on 30/10/2007 which showes improvement.The doctor has stated the treatment can continue for a total period of 9 to 12 months.
              with regards,
             surjit singh
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357139_tn?1220104712
Respected Doctor,
                               This is in continuation of my querry posted above.
We have today got the Haemogram tests done and the results are satisfactory/within reference range except the following;
     MCHC           35,80  g/dl (ref.range 32.00-35.00)
     Eosinophils under Differential % Leukocyte Counts -11.70 %    (ref.range   1.00- 6.00)
      ''                    ''    Absolute    ''        ''             ''       - 0.73 thou/mm3 (ref.range 0.02-0.50)
        I shall be grateful if you please enlighten about the said resutls in the layman's language.Further,please advise if the ATT being taken require any review/change in wake of the aforesaid results.
   with regards,
   surjit singh
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Avatar_n_tn
There is lot information from this site and the pople who are really in confusion can get clarified from here
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Avatar_n_tn
Iam 25yrs old i got effected with T.B to my right sacro iliac joint, iam
under going treatment from the jan of this year,as per my doctors suggestion
i need to take treatment from 12 to 18 months, at earlu stage i used AKT4 for 2 months
and then after Rcinex 600.Now the pain has reduced to maximum but not completly.
I have started working from 8th month of my treatment as per doctors suggestion.I need to sit before computer
for atleast 8hrs,I increased 25 kgs in this year will i become asusual after i get cured
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Avatar_n_tn
Dear doctor,
Recently i got the tb of spine
i took akt4 for three months
That time i have done the esr checkups it was shown like 18,8,10 mm/hr for three months.then i started taking akt3 but my esr level has increased to 25 mm/hr after taking the akt3 medicine.
Now what should i do .shall i continue the akt4 for some more time
Pls provide ur suggestion
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Avatar_n_tn
HELLO DOCTOR,MYSELF BHANU I M IN CHANDIGARH  .DOCTOR I WAS DIAGANOSED WTH POTTS SPINE ON 12JUNE AND AS MY DCTOR RAJ BAHADUR HE TOLD ME TO BE ON BED FRM THAT DAY MY MRI SHOWED ABCESS (abscess) FORMATION.AFTER ONE MONTH I STARTED LOSING POWER IN MY LOWER PART AND APPROX IN 15DAYS LOST POWER BUT SENSATION NTACT..THN GONE THROUGH SURGERY ON 12 AUGUST..08 AND NOW TRYING WALKING WITH WALKER BUT FEW PRTS  GAINING POWER IN PROCESS IS IT GOOD SIGN OF RECOVERY DOCTOR ....DOTOR TOLD TO WEAR BRACE FOR TWO YEARS AS THEY  DID BONE GRAFTING.
                  PLEASE GUIDE AND COMMENT ON RECOVERY POINTS
                                                                                 REGARDS-
                                                                          BHANU SHARMA
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Avatar_dr_m_tn
Pott's Spine is caused by tuberculosis, a bacterial infection. You should also take Anti tubercular therapy. You can visit DOTS centre in Chandigarh, and follow the RNTCP guidelines, Revised National Tuberculosis Control Programme.

You should have proper diet and protein and calcium supplements help in faster recovery. We would also suggest physiotherapy after a period of time.

Take care and come back to us with further queries.

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Avatar_m_tn
Dear Doctor,

My father is 76 years old and recently a month ago he was detected Koch's Spine and he is under medication AKT-4. He is in Bangalore and currently he is taking the medication on a daily basis however past few days his pain has increased tremendously. He is not able to get up and walk and the pain is really killing him. Doctor's told me to continue giving him the AKT-4 (he has been taking this since Aug 14th). I am not sure the cause of this pain and why it is so severe? Does it mean that the infection is not curing or some other reason? I have the MRI, X-Ray reports as well. One of the doctor suggested to do a Biopsy and based on the result find out if surgery needs to be done? I am not sure if surgery is the right solution or should I wait till the TB Infection is completely cured. Considering my father's age can someone in this community share their experience as how long he will have to take AKT medication? What else needs to be done so that the pain reduces? Is the pain because of the infection or something else? My father is a diabetic patient and we have completely controlled his diet and the recent blood sugar report shows a good improvement in his blood sugar level.

I would really appreciate if some one can guide me I really cannot see him suffer through this pain. If someone can provide a good doctor's reference that would be very much appreciated. We are also currently giving him Ayurvedic medicine as supplement (to control diabetes and calcium tablets).

Looking forward for an advice and guidance.

Regards,
Krishnan
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Avatar_f_tn
Hello Dr,
I am 18 and have been diagnosed with Pott's spine on 2nd Feb 2009.
The infection is D12-L1 level.I had been on AKT-4 till july (6 mnths).Now i am on AKT-2.

The latest contrast MRI on 22 Jul shows the following report-
-Near total reduction in paravertebral soft tissue.
-Significant reduction in number and size of erosions at involved D12 and L1 end plates.
-Partial reduction in bone marrow edema and contrast uptake is noted in involved vertebral bodies.
-No other fresh abnormality.

I am perfectly mobile and have no problems in doing my work as such.
My inquiry is-
I have to join Merchant Navy, and the job requires its fair bit of physical activity.I want to know whether the disease will hamper me again in the future????
Will strenous activity like lifting weights about two years from now cause any problems????
There are a few requisites for joining merchant navy-
-Jumping in a swimming pool from 10mtrs height.
-Rowing a boat.
-Wearing a heavy fire fighters equipment
-Jerks and pushes on the ships.
Will i be able to handle these things two years from now?????

Would be grateful for your reply.
Thanking you.
Rachit Bhardwaj (New Delhi)
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Avatar_dr_m_tn
Dear Rachit,

I would suggest you not to join merchant navy till about 6 months to 1 year. You have to gain lot of strength in your muscle, bone and for this you have to take protein, calcium and vitamin supplements with regular weight bearing exercises and swimming and other forms of cardio.

After that you have to assess your strength and only after an orthopedician gives you a green signal i would not suggest you to join merchant navy.

Take care!
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Avatar_n_tn
Kindly help, My husband has been did diagnosed for Kochs Spine Infection and he has been advised to take 2 months bed rest anda course of medication with streptomycin injection daily for its been 2 weeks he has been expriencing pain in his bac and fever daily in the evening and for that he takes a pain killer but is this common just wanted to know how ong will the pain and fever last he is feeling very bad he is 37 years old and kindly suggest.

regards
Deepa
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Avatar_n_tn
i HAVE THE FOLLWING QUERY.
My sis got TB infection, and when it was
detected its was too laste and hence operated
for potts spine at SGRH, Delhi.
She is perfect now -able to walk, bend and do all work.
Her medicines are still going on rcin 600 and solonex 600mg.
Earlier straptmusin was given and later it is stopped
after few sideeffectds.
Doctor says the medicine period is 18months for not taking anyrisk
and shie is perfect now.
I wantt to know a bit about furture.
a. what r future chances of reoccuring of TB
b. Is there any problem in pregnency by this.
c. Whats the sideeffests of this RCIN ,TB medicine.
4. wahts the sucess % moslty in curing TB.
5. any other sugesstion.

thanx in advance

regards
XYZ  
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Avatar_m_tn
which is the better treatment for port spine
AKT 4 or COT
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1417741_tn?1282160979
I seem to have Potts Disease. Needle biopsy was done. culture sent. REsults awaited. But I cannot take the pain. It is too much. Tried all kinds of pain medication nothing works. Doc has started treatment assuming it is potts....but now I cant take acetaminophen because of some interactions. I cannot take Ibuprofen because of some stomach problems I have. Tried Tramadol....didn't work at all........now on Hydromorphone and it is not working either. What do I do? Please suggest any painkiller that will relieve my pain and allow me to lead a normal life until the potts medicines work. Thanks in advance.
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Avatar_m_tn
i am 29/m/oc(left leg amput.above knee in 2004). two year ago i started feeling pain at my back(D8-D9)vertibra, after mri and ct scan i was abvised to go for biopsy to draw the conclusion which stated sympt. of TB and cancer,after further invest. it wad cleared that it is TB(montuox test positive). After a course of AKT-4 for more then 9 months the pain had become less but in morning hrs its still there.further ,pain in the joints, specially finger and wrist joints had increased even after uric acid is normal.

Kindly suggest the future course of action.
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1166907_tn?1263105248
My Husband has been on treatment for Potts disease since April 2010.
He is much better though initially he had all sorts of problems with this disease. He had to undergo surgery for decompression and drainage of abcess (abscess) twice.

In August he had the surgery and after that he was given 60  streptomycin injections and also Moxif 400. Doctors told us that the medication has to continue for 1 year. Pyzina was stopped. Now he is on Ricinex 600, Ethambutol 1000 and Moxif 400.

Lately he has been having blurring of vision. This we believe is due to medication side effects.

My question is can anything be done to counter this effect? How long is ethambutol required to be continued?

Also, the 1 year time period given to us for medication is from April 2010 when disease was diagnosed or from August 2010 when surgery was performed?

Will be grateful for your response.
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Avatar_m_tn
I am currently undergoing ATT therapy for potts spine-- involved abscess, psoas abscess.....drained. No neurology when diagnosed. Now completing 7 months (only medication no surgical treatment)
but pain is not completely gone....still have pain in the back if i sit for 4-5 hrs. can walk around on a leveled surface.
how long does it going to take for complete recovery?????
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Avatar_m_tn
Hi Sir,
six months ago i got pott's on L4 and i am taking medicine since March (AKT4) now sixth month is running, how long i need to have medicine, recently i took MRI, it shows very good improvement. is there any affect in future to do exercises, shall i get my normal life as i was earlier. please let me know.
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Avatar_m_tn
Hello Doctor,
                    My wife aged 39 has been infected with TBM and has lost 7 kgs,  and is on medication since 12th July with AKT-4 along with Anti Seizure tablets. Now doctor has prescribed with  Septromycin inj and also Moxif 400. She has Fever ranging 101 to 103 daily. When would the fever subside.
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Avatar_m_tn
hi
   I am aszad 23 yrs old frm hyderabad. I have upper left back pain and after visiting ortho he told me to get chest and dorsal spine x-ray and also an MRI, I am waiting for results (tomorow i will be getting) and he has given me these drugs
1.accelofenac
2.pantop
3.shelcal
4.mutli-vitamin
                 I have been using them since 0ne week and pain has lessen but when i go to office and sit on chair (for 6 hours) pain starts increasing..
my doc thinks it may be potts spine.. I am scared and want you to help me out in curing  this disease. is this very serious kindly help me out..Thanks in advance..
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Avatar_m_tn
Dear Sir,
My father who is 59 years old had been suffering from backache since last 3-4 months and the doctors could not actually diagonise for so long and has opined that it must be a Spondylitis TB affecting lower thoracic D11 D12 region and he is not been able to move or stand for long and will always be trying to lie on his stomach saying that is the only position where he finds less pain. And at times he suddenly bursts with tears for the pain. Doctors are still trying to investigate whether the problem is actually TB or something else. Right now he is admitted to BGS Global Hospital, Bangalore.
He is not able to go for a MRI due to his back problem and doctors will be providing anaesthasia to the region and take for MRI.
Thank you for providing the forum.
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Avatar_m_tn
Dear Sir,
My father who is 59 years old had been suffering from backache since last 3-4 months and the doctors could not actually diagonise for so long and has opined that it must be a Spondylitis TB affecting lower thoracic D11 D12 region and he is not been able to move or stand for long and will always be trying to lie on his stomach saying that is the only position where he finds less pain. And at times he suddenly bursts with tears for the pain. Doctors are still trying to investigate whether the problem is actually TB or something else. Right now he is admitted to BGS Global Hospital, Bangalore.
He is not able to go for a MRI due to his back problem and doctors will be providing anaesthasia to the region and take for MRI.
Thank you for providing the forum.
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Avatar_m_tn
My mother age 53 is suffering from potts spine , she is taking AKT4 for 4 months now she vomits as soon as she takes medicine , She is growing weak by weak day by day (now she find difficulty even when getting up from bed , walking  etc) Kindly suggest the hospital where she can be treated in mumbai & thane district
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Avatar_m_tn
my friend has had a Surgery for potts spine L3 L4 (Instrumentation), done 2 months ago... she has been asked to start physio. wat exercises is she allowed now? she also has a taylors brace. how long does she have to wear it?
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Avatar_f_tn
Sir,

I had pott's spine at the age of 19. I had undergone full treatment. I am well now.I am getting married now. Somebody told me that there might be problem in conceiving a baby.Is this possible ? Please reply n help me out in this.

Regards
Ashna
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Avatar_m_tn
Hello Dr. Jain,

I am Indore based and my mom, aged 49, is under treatment of Pott's spine on ATT since 4 months. There was water detected in her lungs which was drained and after that she is getting acute spine pains. We are getting treatment from Dr. Apoorva Pauranik. There are few comments from doctor:
1. MRI features suggesting straightened cervical spine with maintained allignment? Secondary to muscle spasm.
2. Cervical degenerative spondylosis with multilevel with mutilevel degenerating IV discs.
3. At C5-6/C6-7 mild diffuse disc buldge is noted and a small left paracentral protrusion at C6-7 without significant canal or foraminal compromise.
4. Small posterocentral protrusion is noted at C7-D1 without significant canal or formanil compromise.  

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Avatar_m_tn
My Mom is detected with pott's spine, I have some doubts.. I want to send the MRI and other reports for your opinions.. please help .. how can I send that.. My mom is based in Bikaner, Rajasthan and I am in Bangalore..
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Avatar_m_tn
Dear Sir,

I was found with pleural effusion last 17 october 2012 . I was prescribed R-cinex-600 mg and combutol-1000mg daily bases,
you could be suggest me these all are medicine when stoped time because i am continue this medicine last 8th Month,


Thanks,
Naman
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