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Suggest Treatment For Stiff Back
Question: My wife suffering from stiff back like muscle catch for the last 9 months. No fever,cough,cold. As the symptomatic treatment does not show any infection only pain management done with little pain killers. Now after thorough checkup by MRI it reports that Infective spondilitis with pre verbetral collection at D1,D2 and D10,D11.and collapse of D10. Now she is able to walk and sit but feeling discomfort when sleeping as she could not move freely. The doctor suggesting Spine surgery to remove deformity and treatment for TB. She is weighing 55 kgs. But we are afraid of Spine surgery. Kindly suggest alternative treatment along with TB drugs.
Brief Answer:
If required, surgery is safe
Detailed Answer:
Hello
Thanks for posting
I have gone through your query and understand your concern. In my opinion surgery is required if -
1. There is increasing loss of muscle power in lower limb In spite of Anti tuberculosis drugs (ATT).
2. Loss of sensation that is numbness in lower limb.
3. Loss of bladder or bowel control that is bed wetting.
4. Increasing pain
Does she has any of the above features, please share.
Are there any Improvement/worsening of her condition after ATT? What is the duration of ATT drugs?
For now she may continue with the ATT drugs, strict bed rest, may use brace (Taylor/ASHE) while sitting/standing to have meal.
Take care and I shall be glad to answer any further query.
Regards
If required, surgery is safe
Detailed Answer:
Hello
Thanks for posting
I have gone through your query and understand your concern. In my opinion surgery is required if -
1. There is increasing loss of muscle power in lower limb In spite of Anti tuberculosis drugs (ATT).
2. Loss of sensation that is numbness in lower limb.
3. Loss of bladder or bowel control that is bed wetting.
4. Increasing pain
Does she has any of the above features, please share.
Are there any Improvement/worsening of her condition after ATT? What is the duration of ATT drugs?
For now she may continue with the ATT drugs, strict bed rest, may use brace (Taylor/ASHE) while sitting/standing to have meal.
Take care and I shall be glad to answer any further query.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
The diagnosis came just two days back and the ATT drugs have been started just one day back and started rest from other works. As of now she is taking rest without house work, she is able to walk in house, doing very simple works, no bed wetting. After taking rest from other work, no increasing in pain. But there is stinging sensation in hands near shoulder, feeling itching and burning sensation around neck & shoulder. Feeling more comfortable in sitting mode.
Visiting physician today and will follow his guidance. Kindly advise
Visiting physician today and will follow his guidance. Kindly advise
Brief Answer:
Rest along with wait and watch policy
Detailed Answer:
Hello
It's good to see you.
I have gone through your reply.My suggestion is continue with the treatment as discussed earlier and watch the sign as told earlier.
I am quite hopeful of Improvement with TB drugs and she may not require surgery.
Hope this help.
Rest along with wait and watch policy
Detailed Answer:
Hello
It's good to see you.
I have gone through your reply.My suggestion is continue with the treatment as discussed earlier and watch the sign as told earlier.
I am quite hopeful of Improvement with TB drugs and she may not require surgery.
Hope this help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
As informed yesterday I have visited a good physician, he is also suggesting surgery at the very earliest after examining my wife. The blood test report after his visit showed ESR 16 against 76 two weeks back. WBC also with in limits. But the HB is 7.4 against 7.0 two weeks back.
Please note that these changes are with in two days of starting ATT and bed rest. The burning sensation and pain has decreased with bed rest. Can it shows this drastic changes in two days. The ATT Drugs using are Forcex two tabs before food in morning and Benadon 40 after lunch.
My worry is that with the collapse of D10 there is forward bending of shoulder, can it be corrected and release spine nerve that compressed without surgery, offcourse after improvement with ATT. If so in what method - is it physio therapy or drugs or any other way.
Kindly advise as I am in a fix to go for surgery immediately without waiting or can I wait and plan for alterative treatment.
Please note that these changes are with in two days of starting ATT and bed rest. The burning sensation and pain has decreased with bed rest. Can it shows this drastic changes in two days. The ATT Drugs using are Forcex two tabs before food in morning and Benadon 40 after lunch.
My worry is that with the collapse of D10 there is forward bending of shoulder, can it be corrected and release spine nerve that compressed without surgery, offcourse after improvement with ATT. If so in what method - is it physio therapy or drugs or any other way.
Kindly advise as I am in a fix to go for surgery immediately without waiting or can I wait and plan for alterative treatment.
Brief Answer:
take maximum rest and minimal sitting
Detailed Answer:
Hello
I have gone through your reply and going by your own description,your wife is able to walk around with full control on urine (bladder and bowel function intact),pain and burning sensation has decreased .It is based on this information I feel you may continue with TB drugs and rest in lying down position with sitting /standing only for meal and to visit toilet (Western style) that too with belt as told earlier.
Since,physical examination is not possible it is my sincere advice to have second opinion and may discuss about the above said points with the doctor.
The blood report do not change in 2 days time.The forward bending Can be prevented by taking maximum rest and minimal sitting.
Hope this answer your query and do not hesitate to ask If you have more queries.
Take care
take maximum rest and minimal sitting
Detailed Answer:
Hello
I have gone through your reply and going by your own description,your wife is able to walk around with full control on urine (bladder and bowel function intact),pain and burning sensation has decreased .It is based on this information I feel you may continue with TB drugs and rest in lying down position with sitting /standing only for meal and to visit toilet (Western style) that too with belt as told earlier.
Since,physical examination is not possible it is my sincere advice to have second opinion and may discuss about the above said points with the doctor.
The blood report do not change in 2 days time.The forward bending Can be prevented by taking maximum rest and minimal sitting.
Hope this answer your query and do not hesitate to ask If you have more queries.
Take care
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
Dr. Mukesh Chugh
Orthopaedic Surgeon, Joint Replacement
Practicing since :1997
Answered : 1619 Questions
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