How can a woman cope with her spinal tuberculosis at 58?

Question

Hi doctor,

My aunt is 58 years old. She was diagnosed with TB (tuberculosis) spine complications. She is experiencing severe spinal pain, which affects her legs and makes it difficult for her to walk on her own due to the intense pain. She also has a persistent cough, weight loss, and reduced appetite. Additionally, she has watery stools, and sometimes fluid-like discharge is present. These symptoms have been present for two weeks now, but she has started treatment. She had an X-ray before the treatment started, which confirmed the disease, but I want to be sure she is receiving the right treatment because she is still weak.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Primary complaint:

Severe spinal pain
Leg weakness (unable to walk unaided).
Chronic cough.
Weight loss.
Loss of appetite.
Watery stool.
Fluid discharge.
Recently diagnosed with tuberculosis of the spine (based on X-ray).
Under anti-TB treatment (exact medications unknown).

Possible conditions based on symptoms:

Spinal tuberculosis (TB Spine/Pott's Disease):

Confirmed by X-ray, this condition can cause severe back/spine pain.
Spinal nerve compression, leading to weakness or numbness in the legs.
Cold abscess formation, which can leak fluid.
Constitutional symptoms: weight loss, appetite loss, chronic fatigue. If not managed promptly, it can lead to permanent nerve damage.

Osteoporosis is common in women over 50, especially with poor nutrition or chronic disease. It can coexist with TB and worsen spinal bone fragility. It may cause:

Vertebral fractures or spinal collapse.
Severe back pain.
Reduced mobility and further risk of nerve compression.
If fluid leakage is present and bones are fragile, spinal instability from both TB and osteoporosis must be considered.

Malnutrition or systemic TB spread: Chronic diarrhea-like stools, fatigue, and weight loss may indicate

TB spreads beyond the spine (abdominal TB, intestinal irritation).
Secondary infections due to weakened immunity.
Malnutrition-related muscle wasting.

Recommended investigations:

MRI (magnetic resonance imaging) of the spine (not just X-ray) to assess nerve compression, spinal cord involvement, abscesses, and osteoporotic fractures.
Blood tests for calcium, vitamin D, bone density markers, nutritional status, CBC (complete blood count), CRP (C-reactive protein), and ESR (erythrocyte sedimentation rate).

Management considerations:

Ensure vitamin B6 (pyridoxine) is given to prevent nerve damage during TB therapy.
Provide nutritional support with a high-protein, high-calorie diet plus calcium and vitamin D supplementation.
Consider surgical drainage of abscesses or spinal stabilization if there is nerve compression or instability.
Physiotherapy (as tolerated) for mobility and strength.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.