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Spinal Tuberculosis USMLE Notes & Mnemonics contains all the high-yield points you need to know.

  • Spinal Tuberculosis (Pott’s Spine): A form of tuberculosis that affects the spine, leading to vertebral destruction, deformity, and potential neurological complications.


  • Common in areas with high prevalence of tuberculosis.
  • Can affect any age, but more common in young adults. (Ref)


  • Mycobacterium tuberculosis infection in the spine.
  • Often secondary to primary TB infection elsewhere in the body.
  • Predominantly affects the thoracic and lumbar vertebrae.

Clinical Features:

  • Back Pain: Persistent and localized, often worsens at night.
  • Spinal Deformity: Kyphosis or gibbus formation in advanced cases.
  • Neurological Deficits: Due to spinal cord or nerve root compression (e.g., weakness, numbness, paralysis).
  • Constitutional Symptoms: Weight loss, fever, night sweats (if active TB).
Spinal Tuberculosis visual mnemonic
Spinal Tuberculosis visual mnemonic


  • MRI or CT: Imaging of choice, showing vertebral destruction, abscess, or soft tissue involvement.
  • Biopsy and Culture: Confirmatory for Mycobacterium tuberculosis.
  • Mantoux Test (Tuberculin Skin Test) and Interferon-Gamma Release Assays (IGRAs): To detect TB infection.


  • Antitubercular Therapy (ATT): Standard multi-drug regimen for TB (e.g., isoniazid, rifampicin, pyrazinamide, ethambutol).
  • Surgical Intervention: In cases of severe deformity, neurological deficits, or failure of conservative treatment.
  • Spinal Bracing: To prevent deformity progression in some cases.


  • Spinal Instability
  • Severe Kyphosis
  • Neurological Impairment
  • Paraplegia or Quadriplegia (in severe cases)

Mnemonic: “SPINE TB

  • Spinal involvement
  • Pain in the back
  • Infection (Mycobacterium tuberculosis)
  • Night symptoms (pain, sweats)
  • Epidemiology (more common in high TB prevalence areas)
  • Tubercular origin
  • Bone destruction and deformity

Chart: Spinal Tuberculosis Features and Management

FeatureDescriptionManagement Strategy
Affected RegionMainly thoracic and lumbar vertebraeATT, possible surgical intervention
SymptomsChronic back pain, spinal deformityPain management, ATT
Diagnostic TestsMRI/CT, biopsy, Mantoux test, IGRAsConfirm TB infection, assess extent
Treatment ApproachLong-term ATT, surgery if necessaryMulti-drug regimen, monitor response

Note: In the context of the USMLE, spinal TB often presents as a patient with persistent back pain and a history or risk factors for tuberculosis. Imaging findings, the necessity of a lengthy course of ATT, and the potential for severe complications like neurological impairment are key points to remember. Surgical intervention is reserved for specific indications.

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