Pott's disease history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D.; Aravind Kuchkuntla, M.B.B.S[2]
Overview
The history and symptoms of Pott's disease depend on the stage of disease, affected site, and presence of complications. Back pain is the earliest and most common symptom of Pott's disease. Other constitutional symptoms include fever, night sweating, anorexia, and weight loss.
History and Symptoms
Clinical features in spinal tuberculosis depend on the stage of infection, location and number of vertebra involved.
The features include the following:[1][2]
- Chronic back pain is the common presenting symptom with associated stiffness and spasm of the muscles of the back. [3]
- Cold abscess and spine deformity presents as localized swelling on the back.
- Constitutional features of tuberculosis are present in 30% of patients, majority of the patients remain asymptomatic. The features of active disease include: malaise, loss of weight and appetite, night sweats, evening rise in temperature, generalized body aches, and fatigue.
Neurological Symptoms
Neurological symptoms depend on the level of infection:[4]
- Atlanto axis level: Patients present with torticollis.[5]
- Cervical level: Patients present with pain, weakness, and numbness of the upper and lower extremities. Progressive cord compression can result in tetraplegia.[6]
- Thoracic level: Kyphosis is common in thoracic involvement,and significant cord compression can result in paraplegia.[7][8][9]
- Lumbar or Sacral level: Compression of cauda equina can result in pain, weakness, numbness, and pain, with paraplegia.
References
- ↑ Shi T, Zhang Z, Dai F, Zhou Q, He Q, Luo F; et al. (2016). "Retrospective Study of 967 Patients With Spinal Tuberculosis". Orthopedics. 39 (5): e838–43. doi:10.3928/01477447-20160509-03. PMID 27172367.
- ↑ Del Puppo L, Janssens JP, Kherad O, Younossian AB, Frésard I (2016). "[Bone tuberculosis: when consider this diagnosis?]". Rev Med Suisse. 12 (504): 262–5. PMID 26999996.
- ↑ Yadla M, Sriramnaveen P, Kishore CK, Sivakumar V, Reddy YS, Sridhar AV; et al. (2015). "Backache in patients on maintenance hemodialysis: Beware of spinal tuberculosis". Saudi J Kidney Dis Transpl. 26 (5): 1015–7. doi:10.4103/1319-2442.164595. PMID 26354582.
- ↑ Macke JJ, Engel AJ, Sawin PD, Bancroft LW (2015). "Tuberculosis of the cervical spine". Orthopedics. 38 (5): 280, 332–5. doi:10.3928/01477447-20150504-01. PMID 25970354.
- ↑ Gao YZ, Xing S, Gao K, Shi XG, Zhang JY, Yu ZZ; et al. (2016). "[Anterior retropharyngeal debridement combined with posterior atlantoaxial fusion for atlantoaxial Tuberculosis]". Zhonghua Yi Xue Za Zhi. 96 (19): 1495–9. doi:10.3760/cma.j.issn.0376-2491.2016.19.007. PMID 27266494.
- ↑ Xing S, Gao Y, Gao K, Zhang G, Yu Z (2016). "Anterior Cervical Retropharyngeal Debridement Combined With Occipital Cervical Fusion to Upper Cervical Tuberculosis". Spine (Phila Pa 1976). 41 (2): 104–10. doi:10.1097/BRS.0000000000001169. PMID 26679892.
- ↑ Kaushal S, Dora SK, Thakur S (2015). "Spinal Tuberculosis with Paraplegia in Pregnancy". JNMA J Nepal Med Assoc. 53 (198): 123–5. PMID 26994033.
- ↑ Liu Z, Wang X, Xu Z, Zeng H, Zhang P, Peng W; et al. (2016). "Two approaches for treating upper thoracic spinal tuberculosis with neurological deficits in the elderly: A retrospective case-control study". Clin Neurol Neurosurg. 141: 111–6. doi:10.1016/j.clineuro.2016.01.002. PMID 26773701.
- ↑ Rasjido Ldel V, Vargas MJ, Fajre LE, Luciardi HL (2014). "[Pott disease in thoracic spine]". Medicina (B Aires). 74 (5): 391. PMID 25347901.