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At Complete Orthopedics, our surgeons specialize in diagnosing and treating spinal infections, including tuberculosis of the spine<\/strong>, also known as Pott\u2019s disease<\/strong>. We take a comprehensive approach that combines modern imaging, medical therapy, and, when needed, advanced surgical techniques to restore stability and protect the spinal cord.<\/p>\n Our offices throughout New York City and Long Island are connected with six leading hospitals that provide the latest diagnostic and surgical technologies. Scheduling an appointment with one of our spine specialists is simple\u2014online or by phone.<\/p>\n Tuberculosis remains one of the world\u2019s most common infectious diseases. While it primarily affects the lungs, it can also spread to other parts of the body. Spinal tuberculosis<\/strong> accounts for up to half of all bone and joint tuberculosis cases. It is most common in developing countries and among individuals with weakened immune systems, such as those with HIV, diabetes, or poor nutrition.<\/p>\n Spinal tuberculosis is caused by the spread of Mycobacterium tuberculosis<\/em> bacteria from the lungs or another infected site to the bones of the spine. The bacteria travel through the bloodstream or lymphatic system, where they infect the vertebrae and surrounding tissues.<\/p>\n Over time, this infection destroys bone and disc tissue, leading to collapse of the spine, deformity, and pressure on the spinal cord or nerves. The most commonly affected areas are the lower thoracic and upper lumbar regions.<\/p>\n The spine is made of vertebrae separated by discs that cushion and support movement. Behind the vertebrae runs the spinal cord, which carries nerve signals to the body. When tuberculosis infects the spine, it damages the front portion of the vertebrae and discs. As bone weakens, the spine may collapse forward, forming a sharp bend called a kyphotic deformity<\/strong>. If the infection spreads into the spinal canal, it can compress the spinal cord, causing weakness or paralysis.<\/p>\n Symptoms usually develop slowly and may not be obvious at first. Common signs include:<\/p>\n Persistent back or neck pain<\/p>\n<\/li>\n Stiffness and limited spinal movement<\/p>\n<\/li>\n Fatigue, fever, or night sweats<\/p>\n<\/li>\n Unexplained weight loss<\/p>\n<\/li>\n Swelling or tenderness over the spine<\/p>\n<\/li>\n Weakness, tingling, or numbness in the arms or legs<\/p>\n<\/li>\n Difficulty walking or maintaining balance<\/p>\n<\/li>\n In advanced cases, loss of bladder or bowel control<\/p>\n<\/li>\n<\/ul>\n Without treatment, spinal tuberculosis can cause severe deformity and permanent neurological damage.<\/p>\n Diagnosis begins with a detailed medical history, physical examination, and review of symptoms. Doctors look for signs such as spinal tenderness, stiffness, and nerve changes.<\/p>\n Imaging tests<\/strong> are key:<\/p>\n X-rays<\/strong> show bone destruction or deformity.<\/p>\n<\/li>\n MRI<\/strong> reveals infection in soft tissues, abscesses, and spinal cord compression.<\/p>\n<\/li>\n CT scans<\/strong> provide detailed bone images and help detect early disease.<\/p>\n<\/li>\n Laboratory tests<\/strong> such as blood work, TB skin test, or interferon-gamma release assays help confirm infection.<\/p>\n<\/li>\n Biopsy<\/strong> may be performed to collect tissue for culture and confirm the presence of Mycobacterium tuberculosis.<\/em><\/p>\n<\/li>\n<\/ul>\n Spinal tuberculosis is often classified by location<\/strong> and severity<\/strong>:<\/p>\n Location:<\/strong> Cervical (neck), thoracic (upper back), lumbar (lower back), or sacral (pelvic) spine.<\/p>\n<\/li>\n Stage:<\/strong> Early (no neurological symptoms) or advanced (neurological impairment or deformity).<\/p>\n<\/li>\n Extent:<\/strong> Single vertebral body, multiple segments, or abscess formation.<\/p>\n<\/li>\n<\/ul>\n Several other conditions can mimic spinal tuberculosis, including:<\/p>\n Pyogenic (bacterial) spinal infections<\/p>\n<\/li>\n Metastatic cancer<\/p>\n<\/li>\n Osteomyelitis from other causes<\/p>\n<\/li>\n Brucellosis<\/p>\n<\/li>\n Degenerative spinal disease<\/p>\n<\/li>\n<\/ul>\n MRI and tissue biopsy help distinguish tuberculosis from these conditions.<\/p>\n Non-Surgical Care<\/strong><\/p>\n The cornerstone of treatment is antituberculosis medication<\/strong>, taken for 9\u201312 months or longer. This regimen typically includes multiple antibiotics to eliminate the bacteria.<\/p>\n Non-surgical treatment also includes:<\/p>\n Bracing:<\/strong> To support the spine during healing.<\/p>\n<\/li>\n Rest and nutrition:<\/strong> To strengthen immunity and aid recovery.<\/p>\n<\/li>\n Physical therapy:<\/strong> Once pain subsides, gentle exercises help maintain mobility.<\/p>\n<\/li>\n<\/ul>\n Patients showing improvement on medical therapy are closely monitored with periodic imaging.<\/p>\n Surgical Care<\/strong><\/p>\n Surgery is recommended for patients with neurological symptoms, spinal instability, severe deformity, or when medical therapy fails.<\/p>\n Common surgical goals include:<\/p>\n Decompression:<\/strong> Removing infected or damaged bone and tissue pressing on the spinal cord.<\/p>\n<\/li>\n Stabilization:<\/strong> Using rods, screws, or bone grafts to restore spinal alignment and prevent collapse.<\/p>\n<\/li>\n Correction of deformity:<\/strong> Straightening severe kyphosis to improve posture and breathing.<\/p>\n<\/li>\n<\/ul>\n Approaches include anterior (front)<\/strong>, posterior (back)<\/strong>, or combined<\/strong> surgeries, depending on the extent and location of infection.<\/p>\n Recovery depends on how advanced the disease was before treatment. Patients often stay in the hospital for several days to a week after surgery. Rehabilitation begins early with light movement, followed by gradual strengthening.<\/p>\n Full recovery can take several months. Patients must continue antituberculosis medication for the prescribed duration to prevent recurrence. Regular follow-up imaging ensures proper healing.<\/p>\n Potential complications of spinal tuberculosis or its treatment include:<\/p>\n Recurrence of infection if medications are not completed<\/p>\n<\/li>\n Residual kyphosis or spinal deformity<\/p>\n<\/li>\n Persistent weakness or numbness<\/p>\n<\/li>\n Infection at the surgical site<\/p>\n<\/li>\n Hardware failure or need for revision surgery<\/p>\n<\/li>\n<\/ul>\n Proper medication adherence and follow-up care greatly reduce these risks.<\/p>\n With timely diagnosis and full medical treatment, most patients recover well. Neurological improvement is possible, even in advanced cases, though some may have lasting weakness or mild deformity. Surgical stabilization provides long-term pain relief and mobility.<\/p>\n Patients who delay treatment or have widespread disease may face a higher risk of paralysis or severe curvature. Early intervention leads to the best outcomes.<\/p>\n Medicare<\/strong><\/p>\n CPT Code 63085 \u2013 Vertebrectomy, thoracic (for decompression of abscess or TB lesion): $472.59 Under Medicare, patients are responsible for 20% of the approved amount after meeting their annual deductible. Supplemental insurance plans such as Medigap, AARP, or Blue Cross Blue Shield generally cover this 20% coinsurance, leaving patients with no additional costs for Medicare-approved procedures. These supplemental plans are designed to work alongside Medicare, ensuring that patients undergoing complex spine surgeries like those for spinal tuberculosis have minimal or no financial burden.<\/p>\n Secondary insurance\u2014such as Employer-Based Plans, TRICARE, or Veterans Health Administration (VHA)\u2014acts as a secondary payer after Medicare processes the claim. Once the deductible is met, the secondary plan may pay the remaining balance, including co-insurance or non-covered items. Deductibles for secondary plans typically range between $100 and $300, depending on the specific policy and whether the procedure is performed in-network.<\/p>\n Workers\u2019 Compensation<\/strong> No-Fault Insurance<\/strong> Example Q. Is spinal tuberculosis contagious?<\/strong> Q. Can spinal TB be cured?<\/strong> Q. How long does treatment last?<\/strong>How Common It Is and Who Gets It? (Epidemiology)<\/h3>\n
Why It Happens \u2013 Causes (Etiology and Pathophysiology)<\/h3>\n
How the Body Part Normally Works? (Relevant Anatomy)<\/h3>\n
What You Might Feel \u2013 Symptoms (Clinical Presentation)<\/h3>\n
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How Doctors Find the Problem? (Diagnosis and Imaging)<\/h3>\n
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Classification<\/h3>\n
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Other Problems That Can Feel Similar (Differential Diagnosis)<\/h3>\n
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Treatment Options<\/h3>\n
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Recovery and What to Expect After Treatment<\/h3>\n
Possible Risks or Side Effects (Complications)<\/h3>\n
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Long-Term Outlook (Prognosis)<\/h3>\n
Out-of-Pocket Costs<\/h3>\n
CPT Code 22610 \u2013 Posterior spinal fusion, thoracic: $316.71
CPT Code 22842 \u2013 Posterior instrumentation, 3\u20136 segments: $185.26
CPT Code 22015 \u2013 Debridement or drainage of paraspinal abscess: $230.99<\/p>\n
If your spinal tuberculosis developed due to occupational exposure or workplace conditions, Workers\u2019 Compensation will cover the entire cost of surgical and medical treatment, including decompression, fusion, instrumentation, and abscess drainage. You will have no out-of-pocket expenses when your claim is accepted.<\/p>\n
If your spinal tuberculosis treatment is required following a motor vehicle accident that worsened or revealed an existing infection, No-Fault Insurance will pay all costs for evaluation, hospitalization, and surgical care. The only potential patient cost may be a small deductible depending on your insurance policy.<\/p>\n
Anita, a 54-year-old patient, required thoracic vertebrectomy (CPT 63085) and posterior fusion (CPT 22610) to stabilize her spine and drain a paraspinal abscess (CPT 22015) caused by spinal tuberculosis. Her total Medicare out-of-pocket costs would have been $472.59, $316.71, and $230.99. Because Anita had supplemental coverage through AARP Medigap, the 20% that Medicare did not pay was fully covered, leaving her with no out-of-pocket expense for her treatment.<\/p>\nFrequently Asked Questions (FAQ)<\/h3>\n
A. No. While pulmonary TB is contagious, spinal TB is not spread from person to person.<\/p>\n
A. Yes. With full antibiotic therapy and proper follow-up, most patients are cured and regain function.<\/p>\n
A. Antibiotic therapy usually lasts 9\u201312 months. Surgery, if needed, shortens recovery time but does not replace medical treatment.<\/p>\n