Role of Nuclear Medicine in TB Spine

Spinal tuberculosis (TB), also known as Pott’s spine, is one of the most debilitating and common forms of extrapulmonary TB. Clinical presentation of spinal TB depends on the stage and site of the disease. The symptoms are usually insidious and progress slowly, leading to delayed presentation and delayed diagnosis. Early diagnosis and rapid intervention can significantly reduce morbidity and mortality. The clinician relies on serological, hematological, and radiological imaging for diagnosis and management of spinal TB. Nuclear Medicine imaging is molecular imaging modality that uses various SPECT and PET radiotracers to evaluate oncological and non-oncological conditions. The past decade has seen a surge in radiotracers, particularly PET tracers, to manage infections like TB. Radiotracers used in nuclear medicine can be utilized in spinal TB for early diagnosis, identifying the most appropriate biopsy site, evaluating disease extent, detecting drug resistance, and monitoring treatment response. The following chapter aims at understanding the various features of nuclear medicine molecular imaging that can be used in the management of spinal TB.