Can ordinary back pain lead to paralysis? Doctors remind you: Be careful if this thing grows on your bones!

"I thought it was just a minor problem at first, but I almost couldn't stand up again." Aunt Zhang, 50, was suffering from thoracic tuberculosis and nearly became a long-term paraplegic. After a successful surgery at Jinyintan Hospital, she can now get out of bed and move around freely.

Two years ago, Aunt Zhang often felt back pain and thought she had a herniated disc. In July 2022, she went to the hospital for a checkup because the pain became unbearable. It turned out that she was infected with tuberculosis and the tuberculosis bacteria had metastasized to the bones, causing thoracic tuberculosis. After a few months of drug treatment, Aunt Zhang's feet began to become numb and cold. Gradually, she couldn't stand up and her lower body gradually became paralyzed.

In mid-February this year, Aunt Zhang came to Jinyintan Hospital with hope. Doctors found that tuberculosis bacteria had eroded the bones and destroyed the 10th and 11th thoracic vertebrae. The dead bones and a large amount of necrotic material compressed the spinal cord. The muscle strength of both lower limbs was level 0, the feeling below the navel was gone, and the thoracic spine had obvious kyphosis. The top priority was to relieve the compression of the lesion.

The picture shows the CT scan before the operation: the 10th and 11th vertebrae are obviously destroyed, the thoracic spine is kyphotic, and an abscess is formed in the spinal canal.

After a full evaluation, the surgical team of Jinyintan Hospital finally determined the plan of "spinal tuberculosis lesion removal + spinal canal decompression + bone grafting and fusion + anterior internal fixation". After more than 4 hours of hard work, the operation was successfully completed, successfully removing the infected and necrotic granulation tissue and dead bone, and performing bone grafting and fusion to correct spinal deformity. On the first day after the operation, Aunt Zhang regained sensation in her lower limbs. "My legs were cold before, but I felt warmer after the operation." Four days later, Aunt Zhang's legs could move, and after 10 days, the muscle strength of both lower limbs had gradually recovered from level 0 before the operation to level 4 (normal muscle strength is level 5). "I thought I would never be able to stand up again in my life. I didn't expect the operation to be so good. I believe I will recover soon!"

Popular Science: Understanding Bone Tuberculosis

1. Tuberculosis does not only grow in the lungs

When it comes to tuberculosis, we usually hear the most about pulmonary tuberculosis, so we naturally think that tuberculosis must grow in the lungs! But the tuberculosis bacillus can spread to any part of the body, and bones are the place where it prefers to spread. Tuberculosis on the bones is also called bone tuberculosis.

Bone tuberculosis is a relatively common non-pulmonary tuberculosis, among which spinal tuberculosis is the most common. In the entire spine, the lumbar spine has the greatest mobility, so the incidence of lumbar tuberculosis is the highest. In recent years, thoracic spine tuberculosis has also become common, while sacral tuberculosis and coccygeal tuberculosis are relatively rare.

2. What are the common discomforts of spinal tuberculosis?

Early pain is continuous dull pain, which may be accompanied by radiating pain. The degree is relatively mild, aggravated by fatigue, coughing or holding heavy objects, relieved by rest, and does not affect sleep. It is easy to be mistaken for lumbar muscle strain or lumbar disc herniation. If the disease lasts for a long time, night pain will occur, affecting sleep. Cervical tuberculosis: neck pain, which may also be accompanied by symptoms such as numbness and fatigue in the limbs. Thoracic and lumbar tuberculosis: symptoms such as localized chest and back pain or lumbar sacral pain.

3. In severe cases, it may cause paraplegia

Due to bone destruction, pus, dead bone and necrotic intervertebral disc can compress the spinal cord and cause paraplegia. The process of paraplegia is that movement disorder appears first, followed by sensory disorder, and urinary and bowel dysfunction appears last.

Experts advise

Ni Zhengyi, director of the Department of Surgery at Jinyintan Hospital, said that not all spinal tuberculosis will lead to paraplegia. The key lies in early detection and early treatment. In the early stage, when there is no neurological damage, treatment can often achieve good results. Therefore, when the body has repeated pain, it is important to distinguish it from ordinary lumbar spondylosis. If you have repeated back pain, low fever, night sweats, cough, numbness of the lower limbs, etc., you should go to a regular hospital in time to avoid delaying the disease.