Pott's disease also known as Pengel's
Disease is a presentation of
extrapulmonary tuberculosis that affects
the spine, a kind of tuberculous arthritis
of the intervertebral joints. It is named
after Percivall Pott (1714-1788), a
London surgeon who trained at Barts.
Scientifically, it is called tuberculous
spondylitis and it is most commonly
localized in the thoracic portion of the
spine
Signs and symptoms
• back pain
• fever
• night sweating
• anorexia
• weight loss
• Spinal mass, sometimes
associated with numbness,
tingling, or muscle weakness of night sweats, fever, weight loss, and
the legs
Diagnosis
• blood tests - elevated
erythrocyte sedimentation rate the sufferer to walk in an upright and
• tuberculin skin test
• radiographs of the spine
• bone scan
• CT of the spine
• bone biopsy
• MRI
Late complications
• Vertebral collapse resulting in some cases, a person with Pott's disease
kyphosis
• Spinal cord compression
• sinus formation
• paraplegia (so called Pott's
paraplegia)
Prevention
Controlling the spread of tuberculosis
infection can prevent tuberculous
spondylitis and arthritis. Patients who
have a positive PPD test (but not active
tuberculosis) may decrease their risk by
properly taking medicines to prevent
tuberculosis. To effectively treat
tuberculosis, it is crucial that patients variety of options. He or she may utilize tuberculosis of the spine that caused
take their medications exactly as
prescribed.
Therapy
• non-operative - antituberculous
drugs have formed or to stabilize the spine.
• analgesics
Since Pott's disease is caused by a
• immobilization of the spine
bacterial infection, prevention is possible
region by rod (Hull)
through proper control. The best method
• Surgery may be necessary,
for preventing the disease is reduce or
especially to drain spinal
eliminate the spread of tuberculosis. In
abscesses or to stabilize the
addition, testing for tuberculosis is an
spine
important preventative measure, as those
• Richards intramedullary hip
who are positive for purified protein
screw - facilitating for bone
derivative (PPD) can take medication to
healing
prevent tuberculosis from forming. A
• Kuntcher Nail - intramedullary
tuberculin skin test is the most common
rod
method used to screen for tuberculosis,
• Austin Moore - intrameduallary
though blood tests, bone scans, bone
rod (for Hemiarthroplasty)
biopsies, and radiographs may also be
Pott's disease, which is also known as used to confirm the disease.
Pott’s caries, David's disease, and Pott's
curvature, is a medical condition of the
spine. Individuals suffering from Pott's Pathophysiology
disease typically experience back pain, Pott disease is usually secondary to an
extraspinal source of infection. The basic
anorexia. They may also develop a spinal lesion involved in Pott disease is a
mass, which results in tingling, combination of osteomyelitis and
numbness, or a general feeling of arthritis that usually involves more than
weakness in the leg muscles. Often, the one vertebra. The anterior aspect of the
pain associated with Pott's disease causes vertebral body adjacent to the
subchondral plate is area usually
stiff position. affected. Tuberculosis may spread from
Pott’s disease is caused when the that area to adjacent intervertebral disks.
vertebrae become soft and collapse as theIn adults, disk disease is secondary to the
result of caries or osteitis. Typically, this spread of infection from the vertebral
is caused by mycobacterium body. In children, because the disk is
3
tuberculosis. As a result, a person with vascularized, it can be a primary site.
Pott's disease often develops kyphosis, Progressive bone destruction leads to
which results in a hunchback. This is vertebral collapse and kyphosis. The
often referred to as Pott’s curvature. In spinal canal can be narrowed by
abscesses, granulation tissue, or direct
may also develop paralysis, referred to as dural invasion, leading to spinal cord
Pott’s paraplegia, when the spinal nerves compression and neurologic deficits. The
become affected by the curvature. kyphotic deformity is caused by collapse
A person with Pott's disease may in the anterior spine. Lesions in the
experience additional complications as a thoracic spine are more likely to lead to
result of the curvature. For example, an kyphosis than those in the lumbar spine.
infection can more easily spread from theA cold abscess can occur if the infection
paravertebral tissue, which can cause extends to adjacent ligaments and soft
tissues. Abscesses in the lumbar region
abscesses to occur. Regardless of the
may descend down the sheath of the
complications that may occur, Pott's
disease is typically slow spreading and psoas to the femoral trigone region and
eventually erode into the skin.
can last for several months or years.
A person who has been diagnosed with
Pott's disease may be treated through a Pott's disease: An old term for
analgesics or antituberculous drugs to get softening and collapse of the vertebrae,
the infection under control. It may also often resulting in kyphosis, a
be necessary to immobilize the area of "hunchback" deformity, which was
the spine affected by the disease, or the called "Pott's curvature."
person may need to undergo surgery in
order to drain any abscesses that may Named for the English surgeon Sir John
Percivall Pott (1714-1788) who
described it