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Suggest Treatment For Spinal Tuberculosis In An Elderly Person
Question: My mum (age : 56) was diagnosed with spine tuberculosis two months before doctors confirmed it after doing CT guided biopsy in the biopsy test they took out yellowish pus and after lab test they confirmed it is spine TB
she took ATT drugs for two months and four days before she took head bath and did stand for 30 mins right from that she is feeling pain at her back which is just below the spot where biopsy was taken Doctors have asked for X-ray and MRI back again once they saw MRI they said there is no remarkable improvement even after taking medicines for 2 months . There are two things they are suspecting now one is it may be malignancy or the spine tb is drug resistant . One more thing is when we admitted my mother in hospital 2 months before they took all malignancy related tests and they confirmed that is not malignancy but they found tuberculosis bacteria and started the treatment is there any other chance for new pus formation even after taking medicines for 2 months please guide me on this i am really worried
she took ATT drugs for two months and four days before she took head bath and did stand for 30 mins right from that she is feeling pain at her back which is just below the spot where biopsy was taken Doctors have asked for X-ray and MRI back again once they saw MRI they said there is no remarkable improvement even after taking medicines for 2 months . There are two things they are suspecting now one is it may be malignancy or the spine tb is drug resistant . One more thing is when we admitted my mother in hospital 2 months before they took all malignancy related tests and they confirmed that is not malignancy but they found tuberculosis bacteria and started the treatment is there any other chance for new pus formation even after taking medicines for 2 months please guide me on this i am really worried
Brief Answer:
Biopsy can rule out malignancy.
Detailed Answer:
Hello,
Thanks for posting your query.
CT guided biopsy is the best way to diagnose a malignancy. If the previous biopsy was suggestive of TB and even after two months of treatment there is no improvement then it can be a drug resistant TB.
As per the attached details, the MRI scan shows lesions at multiple levels in the spine that is more in favor of malignancy. In the previous biopsy no tissue was obtained which could definitely rule out malignancy. The pus showed only few tubercle bacilli. A repeat detailed biopsy and follow up MRI scans are needed to see if there is any improvement. Bone biopsy may be needed to rule out malignancy.
Your mother is getting proper treatment so you need not worry.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Biopsy can rule out malignancy.
Detailed Answer:
Hello,
Thanks for posting your query.
CT guided biopsy is the best way to diagnose a malignancy. If the previous biopsy was suggestive of TB and even after two months of treatment there is no improvement then it can be a drug resistant TB.
As per the attached details, the MRI scan shows lesions at multiple levels in the spine that is more in favor of malignancy. In the previous biopsy no tissue was obtained which could definitely rule out malignancy. The pus showed only few tubercle bacilli. A repeat detailed biopsy and follow up MRI scans are needed to see if there is any improvement. Bone biopsy may be needed to rule out malignancy.
Your mother is getting proper treatment so you need not worry.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am a bit confused with your answer sir are you saying it is malignant due to lesions in multiple places but then why did they confirm it is not malignancy before sir as per you they should bone biopsy also shall I request doctors to go for it which one is preferable either drug resistant or malignancy as per the report as you said they found some tb bacteria so you think that report may not be a proper one can you please suggest some hospitals in XXXXXXX better for this treatment
Brief Answer:
Bone biopsy is better.
Detailed Answer:
Hello.
Thanks for writing again.
Lesions at multiple places can be due to infection or malignancy but more common due to malignancy. In the previous biopsy it is written in the attached reports that "no tissues were obtained and FNAC was inconclusive". In the absence of any tissue, malignancy cannot be ruled out. Rest of the tests were also done to detect any tumor which was not found. But no improvement even after 2 months of treatment indicates that other causes ( other than TB) need to be explored. Bone biopsy is a better way of ruling out malignancy. The treatment she is getting is according to her reports. Changing the hospital will not change the treatment. She will have to undergo more and more tests right from the beginning in a new hospital which will add to her agony. You can consult with her treating orthopedician for better options.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Bone biopsy is better.
Detailed Answer:
Hello.
Thanks for writing again.
Lesions at multiple places can be due to infection or malignancy but more common due to malignancy. In the previous biopsy it is written in the attached reports that "no tissues were obtained and FNAC was inconclusive". In the absence of any tissue, malignancy cannot be ruled out. Rest of the tests were also done to detect any tumor which was not found. But no improvement even after 2 months of treatment indicates that other causes ( other than TB) need to be explored. Bone biopsy is a better way of ruling out malignancy. The treatment she is getting is according to her reports. Changing the hospital will not change the treatment. She will have to undergo more and more tests right from the beginning in a new hospital which will add to her agony. You can consult with her treating orthopedician for better options.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi sir the recent discussion is it has been told by the orthopedician that there are no chances for 99% malignancy because he is able to see more pus in the spot and it should be infection he added because he said that in malignancy solid tumors we can find instead pus he told . This orthopedician suggested for operation to fix the defect part and then he added that he will obtain the germs from there and will start giving antibiotics also Can you please pass your comments on this
Brief Answer:
Surgery will help.
Detailed Answer:
If there is a lot of pus and has damaged a large part of vertebra then surgical fixation is needed. Otherwise the vertebra will collapse. While doing the surgery for fixation they can easily take a sample for pus culture and even do a biopsy if they find anything suspicious. It is best to go with the orthopedician's advice and get the surgical fixation done.
Regards.
Surgery will help.
Detailed Answer:
If there is a lot of pus and has damaged a large part of vertebra then surgical fixation is needed. Otherwise the vertebra will collapse. While doing the surgery for fixation they can easily take a sample for pus culture and even do a biopsy if they find anything suspicious. It is best to go with the orthopedician's advice and get the surgical fixation done.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi sir I requested the doctor to proceed with the operation he said after operation she don't feel pain at all but my family forget to ask what is the post surgery recovery time and he added that she can do regular activities except bending her body can you please tell me if possible in random in how many months she will get back to normal activities
Brief Answer:
Three months.
Detailed Answer:
After a spine surgery, it will take almost 3 months to get back to activity. This much of time will be needed for the bones to regain the strength.
Regards.
Three months.
Detailed Answer:
After a spine surgery, it will take almost 3 months to get back to activity. This much of time will be needed for the bones to regain the strength.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi sir I have a follow up question I travelled to XXXXXXX for my mum and I am in hospital with my mum today I discussed with doctor and he explained the conditions with MRI he said that in the spot where they have taken biopsy before pus accumulation is more now and new pus accumulation is more in lumbar region but doctor is saying now that he completely ruled out malignancy option and he said with spine fusion surgery and some antibiotics my mum can be cured and he added that it may be fungal infection also either MDR or fungal infection only he is suspecting and he ruled out malignancy is he going in right way and can he predict with MRI whether it is malignant or MDR or fungal infection please confirm it's a bit urgent query because he is planning for spine fusion surgery in lumbar region for my mum
Brief Answer:
Bone biopsy will help in ruling out.
Detailed Answer:
Only MRI is not sufficient to rule out malignancy. If spine fusion surgery is being done you can request him to take a bone biopsy during the surgery to completely rule out the malignancy.
Regards.
Bone biopsy will help in ruling out.
Detailed Answer:
Only MRI is not sufficient to rule out malignancy. If spine fusion surgery is being done you can request him to take a bone biopsy during the surgery to completely rule out the malignancy.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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