Pott's disease Classification: Difference between revisions
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==Classification== | ==Classification== | ||
Paraplegia as a result of the infection can be classified into early and late paraplegia based on the activity of the tuberculous infection: | |||
===Based on the Onset of Paraplegia=== | |||
===Early Paraplegia=== | ====Early Paraplegia==== | ||
*It develops in the active stage of tuberculosis infection, commonly seen in adults | *It develops in the active stage of tuberculosis infection, commonly seen in adults within 2years of infection. | ||
*The spinal compression is due to the pressure from the necrotic debris from the damaged bone and intervertebral disc, pus and the granulation tissue. | *The spinal compression is due to the pressure from the necrotic debris from the damaged bone and intervertebral disc, pus and the granulation tissue. | ||
*Spinal compression in spinal tuberculosis can result from other causes causing compression such as subluxation and dislocation due to destruction of anterior column, compression fracture as a result of wide spread infection, spread of infection to the spinal cord, arterial thrombosis and formation of a intra or extramedullary tuberculoma of the spinal cord. | *Spinal compression in spinal tuberculosis can result from other causes causing compression such as subluxation and dislocation due to destruction of anterior column, compression fracture as a result of wide spread infection, spread of infection to the spinal cord, arterial thrombosis and formation of a intra or extramedullary tuberculoma of the spinal cord. | ||
*Emergent treatment is warranted in patients presenting with early paraplegia. | *Emergent treatment is warranted in patients presenting with early paraplegia. | ||
===Late Paraplegia=== | ====Late Paraplegia==== | ||
*It is a complication that develops in a patient with healed tuberculosis. The timing of presentation is variable and can occur 2 or 3 decades after the active infection. | *It is a complication that develops in a patient with healed tuberculosis. The timing of presentation is variable and can occur 2 or 3 decades after the active infection. Typically it is defined as neurological symptoms appearing after 2years of primary infection. | ||
===Stages of Spinal tuberculosis=== | |||
{| class="wikitable" | |||
!Stage | |||
!Description | |||
!Imaging Findings | |||
!Duration | |||
|- | |||
|I | |||
|Stage of implantation, Incipient stage or Predestructive stage | |||
| | |||
*Straightening of the spine or loss of curve | |||
|< 3 months | |||
|- | |||
|II | |||
|Stage of early destruction | |||
|Diminished disk space, paradiskal erosion, kyphosis <10 ( K1) | |||
|2–4 months | |||
|- | |||
|III | |||
|Stage of advanced destruction and collapse | |||
| | |||
*2 or more vertebral involvement with collapse | |||
*Kyphosis 11°-60° (K3) or | |||
*Gibbus > 60° (K3) | |||
|3–9 months | |||
|- | |||
|IV | |||
|Stage of neurological involvement | |||
|Stage III or IV with grade 4 paraplegia | |||
|Variable | |||
|- | |||
|V | |||
|Stage of residual deformity and aftermath | |||
|Kyphosis K1, K2, K3, disease active locally grumbling, reactivated or healed | |||
|3–5 years | |||
|} | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 18:30, 23 March 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Classification
Paraplegia as a result of the infection can be classified into early and late paraplegia based on the activity of the tuberculous infection:
Based on the Onset of Paraplegia
Early Paraplegia
- It develops in the active stage of tuberculosis infection, commonly seen in adults within 2years of infection.
- The spinal compression is due to the pressure from the necrotic debris from the damaged bone and intervertebral disc, pus and the granulation tissue.
- Spinal compression in spinal tuberculosis can result from other causes causing compression such as subluxation and dislocation due to destruction of anterior column, compression fracture as a result of wide spread infection, spread of infection to the spinal cord, arterial thrombosis and formation of a intra or extramedullary tuberculoma of the spinal cord.
- Emergent treatment is warranted in patients presenting with early paraplegia.
Late Paraplegia
- It is a complication that develops in a patient with healed tuberculosis. The timing of presentation is variable and can occur 2 or 3 decades after the active infection. Typically it is defined as neurological symptoms appearing after 2years of primary infection.
Stages of Spinal tuberculosis
Stage | Description | Imaging Findings | Duration |
---|---|---|---|
I | Stage of implantation, Incipient stage or Predestructive stage |
|
< 3 months |
II | Stage of early destruction | Diminished disk space, paradiskal erosion, kyphosis <10 ( K1) | 2–4 months |
III | Stage of advanced destruction and collapse |
|
3–9 months |
IV | Stage of neurological involvement | Stage III or IV with grade 4 paraplegia | Variable |
V | Stage of residual deformity and aftermath | Kyphosis K1, K2, K3, disease active locally grumbling, reactivated or healed | 3–5 years |