Suggest Treatment For Spinal Tuberculosis In An Elderly Person
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
Biopsy can rule out malignancy.
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.
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Bone biopsy is better.
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.
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Surgery will help.
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.
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.
Bone biopsy will help in ruling out.
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.