Recognising signs of TB of the spine

Tuberculosis (TB) remains the world’s top infectious disease, killing 18 Nigerians, adults and children every hour, according to medical experts. It is also a common cause of death in people living with HIV.

The disease is contracted when a person infected with TB coughs or sneezes into the atmosphere. It is an air-borne disease caused by a bacterium called mycobacterium tuberculosis.

While the disease mainly affects the lungs, it can also spread to the spine and other parts of the body.

According to Dr. Mamman Mohammed Lawal, a Consultant Orthopaedic Surgeon and specialist in spine surgery, one of the commonest infections that cause low back pain is tuberculosis.

“Patients with tuberculosis of the spine experience weakness, and when the disease causes permanent damage to the nerves, the patient cannot even walk at all and some develop kyphosis, excessive curve or a hump in the back, popularly called hunch back. It can be as a result of the tuberculosis of the spine because it destroys the spine,” he said.

The spine specialist said tuberculosis causes destructive lesion of the spine such that people feel severe pain when they lie down in the night, adding that “the kind of severe pain they feel at the back does not allow them to lie, so they have to sit up to get some relief.”

He added that other causes of infection to the spine are cancers, tumors and trauma.

Dr. Lawal said the early signs of tuberculosis of the spine were also the signs of tuberculosis. “The first signs include persistent fever, cough, weight loss, loss of appetite, weakness and night sweat.”

He said low back pain was a red flag for tuberculosis of the spine.

“It’s a warning! If you are over 50 years, the first time you are having back pain, please go and see a spine surgeon. It is also important to see a spine surgeon if you are less than 20 years and having low back pain for the very first time,” he said.

The expert said people should also go and see a spine surgeon when they observe the following signs: When they have low back pain and cannot control their urine or faeces; when they have low back pain and weakness in their legs; when their back pain is worse at night or when they are lying down.

“You are supposed to have some relief when you are lying down so any back pain you feel that gets worse when you lie down is a signal to rush to see a spine surgeon,” he added.

He said it was also a red flag to see a spine surgeon when a person had suffered from breast and ovarian cancers before and was now having low back pain.

Early diagnosis and treatment is key to curing tuberculosis of the spine. Some treatments include drugs, surgery and therapy among others.

Nigeria has the highest number of tuberculosis cases in Africa and an estimated 418, 000 new TB cases occurred in the country in 2018.

National Coordinator of the National Tuberculosis and Leprosy Control Programme of the Federal Ministry of Health, Dr Adebola Lawanson, said persistent cough for two or more weeks could be TB and any affected person should see a healthcare provider.

He said diagnosis and treatment including tuberculosis drugs are available free of charge in all Directly Observed Treatment (DOTS) centres nationwide and that the disease is curable.