Definition – Tuberculosis of the vertebral column is called Pott’s disease.
Age – Between 3 to 5 years.
Site – Most common in the lower thoracic region or thoraco-lumbar junctional region.
Route of Infection – Blood-borne infection is the commoner type.
- Central – Starting as diffuse osteomyelitis in the middle of the body.
- Metaphyseal Tuberculosis – Where disease arises near the epiphysis of the bone and therefore close to the intervertebral disc.
- Anterior or Periosteal Variety.
- Appendiceal Tuberculosis.
- Constitutional Features – Like deterioration in general health, loss of weight, poor appetite, lassitude and evening rise of temperature.
- Pain – Initially, it is dull aching in nature while standing or jolting. Gradually, it becomes acute and stabbing in character, situated over the affected vertebrae.
- Stiffness – Patient’s spine becomes increasingly stiff as the disease progresses.
- Swelling – Reveals spinal carries.
General Examination – May demonstrate other signs of tuberculous infection. The patient is malnourished.
- Attitude and Gait –
- In upper cervical disease, head position is like that of torticollis, but face is not rotated.
- In lower cervical disease, head moves backwards and to one side.
- In upper thoracic disease, shoulders are raised and arms are drawn backwards.
- In lower thoracic disease, thorax and head move backwards and the abdomen moves forward.
- Spinal Deformities – Appear late in the disease:
- Rigidity of the Spine.
- Examination for Cold Abscess.
X-ray ( AP and lateral view) of the spine.
- Appropriate symptomatic treatment.
- Surgery – If no sign of improvement is noticed after 6 to 8 weeks of the disease, spinal fusion operation is advised –
- Albee’s operation.
- Brittain’s operation.
Reference: A Handbook of Surgery by Dr Mansi Sharma