Pott’s disease, or spinal tuberculosis, is a significant health concern, especially considering its status as the most common extrapulmonary manifestation of tuberculosis. This condition, where Mycobacterium tuberculosis causes inflammation in vertebrae and intervertebral disc spaces, presents a unique set of challenges in diagnosis and treatment.
A notable case of Pott’s disease involved complications with the suprarenal aorta and an aortic prosthesis, highlighting the difficulties in resection and revascularization. The disease primarily spreads from the lungs to the spine’s paravertebral tissue through the hematogenous route. In a Prospective Study of Thoracolumbar Pott’s Spine, treatment approaches like posterior decompression were explored at a tertiary care center.
Another case report focused on a rare presentation of the disease in the US, where a patient had a retropharyngeal abscess concurrent with spinal osteomyelitis. Globally, spinal tuberculosis is a frequent manifestation of extrapulmonary tuberculosis and should be considered in patients with back pain and tuberculosis risk factors, such as origin from a TB-endemic area, subacute constitutional symptoms, and atypical radiological findings.
Physiotherapy has been shown to be effective in managing pain and disability in Pott’s spine, as detailed in a case study on physiotherapy management. Patients typically present with symptoms like malaise, weight loss, night sweats, muscle spasms, paraspinal swellings, or neurological deficits. However, there have been unusual presentations, such as a case of tuberculosis of the spine presenting only as a painless neck swelling without neurological complications.
In pediatric cases, such as a 4-year-old boy with Pott’s disease of the lumbar spine and bilateral psoas abscesses, treatment with antituberculous therapy and ultrasonographically guided percutaneous drainage of the abscesses has been successful. Moreover, Mycobacterium avium-intracellulare, though rare, can cause spine disease in healthy individuals, as seen in an elderly woman with isolated skeletal involvement mimicking Pott’s disease, who responded well to surgical excision and antibiotic therapy.
