Pott's disease natural history, complications and prognosis

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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

Pott's disease may be complicated by severe vertebral deformity and collapse resulting in kyphosis, cord compression, and paraplegia. It responds well to treatment with improvement of the neurological function and spinal deformity.

Natural History

Spinal tuberculosis is one of the common extra-pulmonary manifestation involving the skeletal system. The common affected sites include the upper lumbar and lower thoracic spine. The infection affects the body of the vertebra or the the intervertebral discs. The progression of the disease is slow with a wide variation in the time of infection to manifest the clinical symptoms of the disease . The average disease duration ranges from 4 to 11 months. Patients take medical help when they develop severe pain, marked deformity or neurological symptoms.[1][2]

Complications

The destruction of the intervertebral disc, body of the vertebra and spread of the infection can result the following complications:[1][3][4]

Prognosis

Pott's disease responds well to treatment with antitubercular treatment. Improvement in pain and neurological deficits are indicators for response to treatment. Prognosis is good in all patients, if a lack of improvement persists other differential must be considered. If other differentials are ruled out and medical therapy is not successful surgery is considered and it has good prognosis.[6]

References

  1. 1.0 1.1 Kumar K (2016). "Spinal tuberculosis, natural history of disease, classifications and principles of management with historical perspective". Eur J Orthop Surg Traumatol. 26 (6): 551–8. doi:10.1007/s00590-016-1811-x. PMID 27435619.
  2. Ratnappuli A, Collinson S, Gaspar-García E, Richardson L, Bernard J, Macallan D (2015). "Pott's disease in twenty-first century London: spinal tuberculosis as a continuing cause of morbidity and mortality". Int J Tuberc Lung Dis. 19 (9): 1125, i–ii. doi:10.5588/ijtld.15.0091. PMID 26260836.
  3. Liu C, Lin L, Wang W, Lv G, Deng Y (2016). "Long-term outcomes of vertebral column resection for kyphosis in patients with cured spinal tuberculosis: average 8-year follow-up". J Neurosurg Spine. 24 (5): 777–85. doi:10.3171/2015.8.SPINE15534. PMID 26745350.
  4. Batirel A, Erdem H, Sengoz G, Pehlivanoglu F, Ramosaco E, Gülsün S; et al. (2015). "The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study". Clin Microbiol Infect. 21 (11): 1008.e9–1008.e18. doi:10.1016/j.cmi.2015.07.013. PMID 26232534.
  5. de Araújo GC, Ferreira Junior Dde S, Escarso Junior Lda R, Gameiro VS (2014). "Spinal tuberculosis presenting with hip abscesses: a diagnostic challenge". BMJ Case Rep. 2014. doi:10.1136/bcr-2014-205569. PMC 4173196. PMID 25253485.
  6. Patankar AP (2016). "Tuberculosis of spine: An experience of 30 cases over two years". Asian J Neurosurg. 11 (3): 226–31. doi:10.4103/1793-5482.145085. PMC 4849291. PMID 27366249.

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