Pott's disease or Tuberculous spondylitis

Posted by e-Medical PPT Thursday, October 7, 2010
Pott's disease is a presentation of extrapulmonary tuberculosis that affects the spine, a kind of tuberculous arthritis of the intervertebral joints. More precisely it is called tuberculous spondylitis.Pott’s disease results from haematogenous spread of tuberculosis from other sites, often pulmonary.  The infection then spreads from two adjacent vertebrae into the adjoining disc space.  If only one vertebra is affected, the disc is normal, but if two are involved the intervertebral disc, which is avascular, cannot receive nutrients and collapses. The disc tissue dies and is broken down by caseation, leading to vertebral narrowing and eventually to vertebral collapse and spinal damage).  A dry soft tissue mass often forms and superinfection is rare.
Spinal tuberculosis (Pott's disease) most commonly involves the thoracic spine. Infection begins in the anteroinferior aspect of the vertebral body with destruction of the intervertebral disc and adjacent vertebrae. The resulting anterior wedging and angulation of adjacent vertebral bodies with disc space obliteration are responsible for the palpable spinal prominence (gibbus) and a classic radiographic appearance. Paraspinal and psoas abscesses can develop, with extensions to the surface or adjacent tissues. Patients present with local pain, constitutional symptoms, or paraplegia secondary to cord compression.

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