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357139 tn?1220104712
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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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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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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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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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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Thanks for the information!!

Regards
Ranga
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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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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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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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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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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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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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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 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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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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Hi,
It is good to hear that surgery has gone well.
The key for draining abcess 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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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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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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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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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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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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There is lot information from this site and the pople who are really in confusion can get clarified from here
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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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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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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 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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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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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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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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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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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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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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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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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 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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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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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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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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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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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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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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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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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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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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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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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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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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