Pott Disease- This is a pathological condition of the spine where a bacterial infection commonly known to cause tuberculosis gets lodged in the spine.1 In this article, we will discuss in detail about the various causes, symptoms, and treatment of Pott Disease or Spinal Tuberculosis.
How Do We Define Pott Disease or Spinal Tuberculosis?
As a general fact, the involvement of the spinal column in tuberculosis is extremely rare and is less than 1%. Nevertheless, Pott Disease is an extremely dangerous type of tuberculosis of the skeletal system, as it can bring along with it neurologic deficits as a result of compression of adjoining neural structures and result in significant spine deformity. Hence, early diagnosis and treatment of Pott Disease is imperative in preventing these potentially serious complications.
Types of Pott Disease or Spinal Tuberculosis
There are two main types of Pott Disease or Spinal Tuberculosis. One is the classic form of Spinal Tuberculosis also called as spondylo-discitis and the other is quite a common form that is spondylitis without disc involvement.
Causes of Pott Disease or Spinal Tuberculosis in Adults and Children
In adults, the intervertebral disc gets involved as a result of spread from adjoining infected vertebra while in children it is generally as a result of vascularized nature of intervertebral discs.
Symptoms of Pott Disease or Spinal Tuberculosis
In Its Active Phase, Individuals May Present With:
- Malaise
- Weight loss 2
- Appetite loss
- Night sweats
- Fever, usually in the evening hours 2
- Stiff and painful spine, especially with movement
- Paraspinal muscle spasms
Diagnosis of Pott Disease or Spinal Tuberculosis
Pott Disease is one of those medical conditions, which are extremely difficult to diagnose radiologically in its early phase. CT and MRI are the main source of studies which help in the confirmatory diagnosis of Spinal Tuberculosis.3
Treatment for Pott Disease or Spinal Tuberculosis
At present, systemic treatment consists of antituberculosis medications before and after surgical debridement of entire focus of infection and successfully reconstructing the spine is the first line of treatment for Pott Disease or Spinal Tuberculosis.
For management of Pott Disease, the decision making can be typically divided into two groups of lesions, one with neurologic complications and one without neurological deficits. In people with neurologic deficits, pharmacotherapy os the first line of treatment and surgical procedures are pretty rare. In cases with neurologic deficits pharmacotherapy is the first choice for treatment as well but in these cases combination of medical and surgical treatments works the best and gives the best outcome.
