Latest techniques in spine surgery focus on Pott’s Disease

Tuberculosis (TB), one of the world’s oldest diseases, remains a global public health concern today. The past decade has experienced an increased prevalence with 33% of untreated patients dying every year. Because of its ability to travel to any organ in the body other than the lungs, it poses greater health risks that can be debilitating and even fatal.

One of the most common sites where TB can pose incapacitating effects is the spine. TB of the spine, or Tuberculous Spondylitis and more commonly known as Pott’s Disease, results from the spread of tuberculosis from other sites, often originating from the lungs. Named after English surgeon Sir John Percival Pott, this disease is typically characterized by a hunchback deformity caused by the collapse of the vertebrae with a resultant spinal cord compression and paralysis.

The debilitating effects of Pott’s Disease start usually as back pain. It may cause what is known as “night cries” in children where they may wake up crying due to pain. It may also be associated with weight loss and generalized body malaise. Over the course of weeks to months, a “gibbus’ develops which is manifested as a hump on the back. If untreated, the spinal column can become unstable which may eventually lead to a deformity or worse, a compression of the spinal cord resulting in different degrees of paralysis. Occasionally, these complications require surgical management in addition to anti-TB medication. Pott’s Disease may well be considered one of the most dangerous forms of musculoskeletal tuberculosis meriting increased awareness.

Cognizant of the problem of Pott’s Disease, Asian Hospital and Medical Center, in collaboration with the Philippine Spine Society, held an operative course and symposium entitled “Advances in the Management of Tuberculous Spondylitis.” Dr. Jose Martin Paiso, section head of Spinal Surgery at Asian Hospital and Medical Center, joined other spine surgery experts to share their knowledge among orthopedic surgeons, neurosurgeons, consultants and residents on the dangers of the disease and the advances in treatment that are now available to ensure an ideal management of the disease.

“The promotion and advancement of orthopedics and spine surgery as one of the pillars of Asian Hospital and Medical Center is just one of many goals the hospital undertakes to provide further medical education to Filipino surgeons, in keeping with its commitment to provide world-class healthcare in the country,” Theo Seiler, chief executive officer of Asian Hospital and Medical Center, related in his welcome address.

Dr. Antonio Sison, president of the Philippine Spine Society, explained the importance of organizing the symposium in the practice of spine surgery: “TB is a disease of poverty which is especially common in the Philippines. We feel this is a relevant step to ensure that local spine surgeons are armed with the latest trends in the surgical treatment of Pott’s Disease so our patients receive better treatment and medical care.”

Among the updates on the treatment and management of Pott’s Disease included the use of additional instrumentation in surgical management. Dr. Jose Manuel Ignacio, head of Scientific Events of the Philippine Spine Society shared: “With the new technologies that we have today, treating Pott’s Disease becomes better. Now we can make the spine stable without having to wear a brace. Modern techniques in instrumentation make it possible for the patient to recover faster without too much downtime.”

The activity commenced with a comprehensive, whole-day symposium with local and international faculty including Prof. Chung Chek Wong from Malaysia and Prof. Jianzhong Xu from Taiwan, who tackled TB of the spine from the history of the disease and medical management, to more modern techniques of surgical management.

On the second day, a live surgical demonstration highlighted the event which showcased the “hybrid approach of surgery”. Featured was the case of an indigent female patient afflicted with Pott’s Disease of the T7 vertebra that caused her to be paralyzed. Her case was managed at the Asian Hospital and Medical Center and her treatment was sponsored by the Asian Charities Inc.

As a result of the sponsored treatment, the patient was able to benefit from a new surgical technique which involved accessing the front part of the spine from a single posterior approach. This entailed the use of modern spinal instrumentation techniques. The state-of-the-art setup in Asian Hospital and Medical Center’s operating room provided a clearer, more in-depth view of the principles of the surgical technique and there was a lively discussion as the surgeon interacted remotely with the participants in the conference room. Also, the patient had an uneventful recovery until she was discharged four days after her surgery and transferred back to her mother hospital.

For more information on the latest in spine surgery, call the Asian Hospital and Medical Center at 771-9000 to 02 or visit www.asianhospital.com.

Dr. Jose Martin Paiso, section head of Spinal Surgery at Asian Hospital and Medical Center and Dr. Jose Manuel Ignacio, head of Scientific Events of the Philippine Spine Society.

(from left) Dr. Chung Chek Wong, Dr. Jianzhong Xu, Dr. Tsiang Fu Tsai and Dr. Tiong Sam Lim