Abstract
This article talks about the L4-L5 Infective Spondylitis which is generally infected L4-L5 and it is also called TB Spine in the Lumbar Spine of Backbone. Generally this infection occurs one in a thousand. It is curable completely and it is not dangerous.. But the treatment should be taken till the end without fail carefully. If the treatment stops in the middle, the treatment should start again from the beginning.
Introduction
The Backbone has the Cervical Spine which is from 1 to 7 , and the Thoracic Spine from 8-12 and then the Lumbar spine which is 13-18 and the last one Pelvic Spine from 19-23. This disease occurs to Cervical spine or in the Lumbar Spine. The treatment like TB Treatment varies from 8 Months to 2 Years
Treatment Procedure
The first step in the Process is disease identification and then Treatment based on the diagnosis. Generally the Symptoms are lower back pain in the Lumbar Spine. Without neglecting the issue, consult the doctor and explain the Issue. If the Pain is not reduced with the tablets or Physiotherapy, ask the doctor to go for an MRI Scan. Don't take the Medication for more than two or three weeks, if not reduced, request the doctor to go for an MRI.
Diagnosis Procedure - After MRI Scan, the Doctors will give the MRI Report with the complete diagnosis. It may cost you the First MRI Would be Rs.10000 to 15000. The MRI doctor identifies the L4-L5 Infective Spondylitis, then Consult the experienced Spine Surgeon or Spine Doctor who is Qualified MD in Neuro Spine. There are Specialized Hospitals in Bangalore Hosmat Hospital and Vinayak Hospital in Pune. These are Specialized hospitals to cure this disease efficiently. They have Qualified Doctors MD in Neuro Spine.
Process - After the doctors diagnosed L4-L5 Infective Spondylitis you can go for the treatment directly without biopsy. Some doctors will insist you to go for a biopsy, discuss with them why you need the biopsy. If we have already identified the TB we can go for the treatment directly. In some rare cases after starting the medication the TB will not respond to the Medication for 1 or 2 Months, then go for Biopsy and test whether the TB is TB- Resistant or Not. TB-Resistant doctors will add 6 Medicines to cure Spondylitis. If TB is Responding with the TB Medication then we can continue the medication as per the advice of the doctor. Biopsy is not required in that case.
This TB Occurred in different ways
1. L4-L5 Infective Spondylitis without Abscess
2. L4-L5 Infective Spondylitis with Abscess
The Abscess has to be tested through Biopsy through CD Guided or Ultrasound whichever is convenient. The Abscess would be fungal or Bacterial Infection or it could be White Abscess without any fungal or bacterial infection.
Whatever it may be, the medication is the same for all the above combinations. The Medicine should be given by the Physician as per the Weight of the Person. Make sure the whole treatment should be monitored and guided by the Expert Physician...
Tests - Cultural Tests for Bacterial or fungal infection and GeneXpert MTB for TB detection.
Side effects for the TB Medication - Generally The TB Medication should be taken by the doctor Guidance. The first two months should be monitored by the doctor because the TB Medication has side effects like Rashes or Itching.
There is a medicine called Pyzana in TB Treatment which is taken in the Night. This medication has side effects which impacts daily medicine intake. The side effect is Uric acid levels, these are monitored through Blood Tests every week for the first two months. This side effect will come for everyone and depends on the amount of Pyzana medicine you take daily. These uric acid levels raise patterns even doctors can not identify this because it varies the uric acid levels daily.
With this Pyzana you take Uric acid medicine which controls the raising of Uric Acid levels which is febutaz and the dosage advised by the doctor. If you don't control the Uric acid levels it leads to Joint Pains in Your body if it is More than 6 in Blood Tests. If it is less than 5 there will be some more issues. You need to maintain the Uric acid levels in your body from 5 to 6 . This is ideal Uric Acid levels in your body.
How to Observe Uric Acid Levels Daily -
From the Medication starting day Use Febutaz with the Pyzana 40 one tablet in the Night, Continue the same medication for 1 Week and do the Blood test at the end of one week - The Tests are Uric Acid . Lever Test, CBC and CRP.
After Test note down the Uric Acid Levels how much there are, Then Skip Uric Acid Medicine Febutaz 1 or 2 days, this will shoot up the Uric Acid levels in your body and then continue the same procedure above after 1 week. Similarly you have to do blood tests every week till you drop the medicine Pyzana , Generally it could be 2 to 3 Months.
Precautions which you take before the Medication
1. Do the Complete blood tests like CBC, CRP, Lever Test, Thyroid Test.
2. Scan the Test whether it is infected other Parts of the body like Lungs
The TB Medication it impacts the Lever and Thyroid in some cases like When the Patient suffering from Liver Problems then the TB Medication impacts lever and if he is facing thyroid Problems then the Patient impacts with this medicine. Be careful while taking this medication with the consultation of the doctor.
Conclusion - The first two months the Patient should be under supervision by the doctor because no one knows how the TB Medicine impacts on the Patient body
Medicines are from the Lupin Pharmaceutical Co - 1. R-Cinex, 2. Combutol and 3. Pyzana
Side effects with the Medicine - Itching, Rashes on the Body and Increase of Uric Acid levels. The Medicine side effects will not come for everyone, whereas Uric acid levels will increase for every one based on the dosage of the Pyzana Medicine.
Before the Medication Starts - Do the Blood Tests - CRP, CBC, Lever and Thyroid functions.
Source - The above article is written with my experience when I underwent the treatment for L4-L5 Infective spondylitis.
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