Usually it is hematogenous spread from another primary focus. Is there any evidence to prove if there is particular tissue element with affinity to Mycobacterium tuberculosis like Staphylococcus aureus osteomyelitis? Is anyone working on this field?
"Usually it is hematogenous spread from another primary focus. "
If it was spread via the blood vascular system, it would affect many other organs (equally?) in a predictable pattern. It is surely far more likely spread via the lymphatic system. Some CSF drains via perineural and perivascular lymphatics into tissues in the body cavity, so organisms could gain access back up this route.
Tuberculous infection is established in the corner
anterior of the vertebra because it follows the path of the plexus
paravertebral vein or cane, migrates to the disc
intervertebral and represents half of the cases. Can
propagate subligamentary anterior or posterior and thus affect
to several vertebral bodies.
The least frequent lesion is the central one, where it is destroyed
the vertebral body and may suffer pathological fracture
by compression.
http://www.medigraphic.com/pdfs/juarez/ju-2006/ju063e.pdf
Tuberculous spondylitis usually begins in the anteroinferior aspect of the vertebral body, with subsequent inflammatory destruction of the bone tissue and necrosis of caseification. As the process stabilizes, the infection spreads to the anterior ligaments, compromising the adjacent vertebral body. The inevitable consequence of the destructive process is the bone collapse and herniation of the disc towards the vertebral body, being the collapse responsible for the vertebral instability and the "hump" characteristic of the condition. Tuberculous abscess usually invades neighboring structures, the epidural space being the most risky, capable of compressing the spinal cord with serious neurological consequences, in other situations it is projected on adjacent tissues such as the psorias muscle and very occasionally in the retropharyngeal space.
http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1024-06752005000200008
"Tuberculous infection is established in the corner
anterior of the vertebra because it follows the path of the plexus
paravertebral vein or cane"
In other words, it does not spread intravenously, or in any part of the blood vascular system. What is cane?
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