Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic, progressive localized lumbar back pain, associated with constitutional symptoms including low-grade evening fevers, night sweats, and unintentional weight loss. History of spinal stiffness, localized tenderness, and potential radicular symptoms or neurological deficits. No history of trauma.
Clinical Examination Findings
Physical examination reveals localized tenderness over the lumbar vertebrae (gibbus deformity may be present). Range of motion is restricted due to pain and muscle spasm. Neurological assessment shows intact motor/sensory function or signs of cord compression (hyperreflexia, weakness). Gait may be antalgic.
Treatment Protocol
Initiate multi-drug antitubercular therapy (RIPE regimen: Rifampin, Isoniazid, Pyrazinamide, Ethambutol). Spinal stabilization via orthotic bracing. Surgical consultation for debridement, decompression, or stabilization if neurological deficits or spinal instability are present. Monitor LFTs and renal function.