Abstract

There was a concern on Mycobacterium tuberculosis spreading to the bone marrow, when it was applied on tuberculous spine infection. This research aimed to study the probability of using autologous bone marrow as a source of mesenchymal stem cell for patients with tuberculous spondylitis. As many as nine patients with tuberculous spondylitis were used as samples. During the procedure, the vertebral lesion material and iliac bone marrow aspirates were obtained for acid fast staining, bacteria culture, and PCR (polymerase chain reaction) tests for Mycobacterium tuberculosis at the Clinical Microbiology Laboratory of Faculty of Medicine Universitas Indonesia. This research showed that there was a relationship between diagnostic confirmation of tuberculous spondylitis based on the PCR test and bacterial culture on the solid vertebral lesion material with the PCR test and bacterial culture from the bone marrow aspirates. If the diagnostic confirmation concluded positive results, then there was a higher probability that there would be a positive result for the bone marrow aspirates, so that it was not recommended to use autologous bone marrow as a source of mesenchymal stem cell for patients with tuberculous spondylitis unless the PCR and culture examination of the bone marrow showed a negative result.

Highlights

  • IntroductionInvasion of Mycobacterium tuberculosis bacteria to vertebral body (tuberculous spondylitis) was one of the causes of vertebral deformities that decreased the quality of life of the patient [1,2,3]

  • Invasion of Mycobacterium tuberculosis bacteria to vertebral body was one of the causes of vertebral deformities that decreased the quality of life of the patient [1,2,3]

  • The diagnosis of tuberculous spondylitis in this research was confirmed by histopathologic examination [13, 14]; it can be concluded that 7 from 9 samples (77,78%) are nonactive spondylitis, whiles 2 out of 9 samples (22,22%) are active spondylitis confirmed by positive Mycobacterium tuberculosis culture [13, 15]

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Summary

Introduction

Invasion of Mycobacterium tuberculosis bacteria to vertebral body (tuberculous spondylitis) was one of the causes of vertebral deformities that decreased the quality of life of the patient [1,2,3]. The Subroto Sapardan Total Treatment for tuberculous spondylitis cases with severe defects used the tricortical bone autograft that was obtained from the iliac bone in order to fill the gap defect [4], there were still around 5% of fusion failure cases after treatment. Mesenchymal stem cell was a special cell that was produced from the bone marrow, fat tissue, umbilical blood, amniotic fluid, placenta, teeth pulp, tendon, synovial membrane, and muscle [5]. The bone marrow was a source of mesenchymal stem cell that has been widely used for tissue reconstruction for bone defect healing due to its composition of osteogenic precursor cells [5, 6]. Bone marrow was obtained by aspiration technique so that traumatic

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