POTT

DISEASE
( Tuberculous Spondylitis)
CASTILLO, Odie Carl
MARASIGAN, Jhairah
POTTS DISEASE
Is a spine infection associated with
tuberculosis that is characterized by
bone destruction, fracture, and
collapse of the vertebrae, resulting in
kyphotic deformity.
Causative Agent
Pott's disease can develop when
air that contains the
tuberculosis-causing bacteria
Mycobacterium tuberculosis is
inhaled into the lungs. From the
lungs, an infection can spread to
the spine. The spread is
hematogenous ie transmitted
through the blood.
Clinical Manifestation

● The clinical presentation of spinal tuberculosis

is variable. The manifestations depend upon
the duration of illness, severity of the disease,
site of the lesion, and presence of associated
complications including deformity and
neurological deficit.

● Uncomplicated Disease
● Complicated Disease
Sign & Symptoms
Back Pain
Fever
Night Sweating
Anorexia, Weight Loss
Spinal mass
Sometimes associated with numbness,
tingling, or muscle weakness of the legs
Diagnostic test

● Blood Test
● X-ray
● Tuberculin test
● CT of the spine
● MRI
● Bone Biopsy
Diagnostic test

● Blood Test
● X-ray
● Tuberculin test
● CT of the spine
● MRI
● Bone Biopsy
TREAMENT

● Most patients affected by spinal

tuberculosis can be successfully treated
conservatively with chemotherapy,
external bracing and prolonged rest.
However, kyphotic deformity, spinal
instability and neurological deficit are often
associated with a conservative approach
TREAMENT

● The treatment protocol is formulated

based on the presence or absence of
neurological involvement. In case of
neurological involvement usually,
pharmacotherapy is preferred over surgery.
The anti-tubercular medications employed
in the pharmacotherapy are Isoniazid,
Rifampicin, Ethambutol, and Pyrazinamide
 Nursing Diagnosis

• impaired skin integrity

• Autonomic dysreflexia
• Deficient fluid volume
• Anxiety
• Impaired physical
mobility
• Disturbed body image

• Ineffective airway
clearance
• Risk for aspiration
• Ineffective breathing
pattern
• Acute pain
• Risk for infection

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 Nursing
Management

As with all spinal injuries, suspect

cord damage until proved
otherwise. Apply a properly sized
cervical collar if cervical injury is
suspected.

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 Nursing
Management

During the initial assessment and

X-rays, immobilize the patient on
a firm surface.

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 Nursing
Management

Offer the patient comfort and

reassurance, talking to him
quietly and calmly. Remember,
the fear of paralysis will be
overwhelming. Allow a family
member who isn't too distraught
to stay with him.

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 Nursing
Management

If the injury necessitates surgery,

administer prophylactic
antibiotics as ordered.
Catheterize the patient, as
ordered, to avoid urine retention,
and monitor defecation patterns
to avoid impaction.

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 Nursing
Management

If the patient has a halo or skull tong

traction device, clean the pin sites daily
and provide analgesics for headaches.
During traction, turn the patient often to
prevent pneumonia, embolism, and skin
breakdown. Perform passive range-of-
motion exercises to maintain muscle tone.
Use a rotating bed, if available, to facilitate
turning and avoid spinal cord injury.

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 Nursing
Management

Position the patient properly according to

injuries to avoid aspiration.

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 Nursing
Management

Watch closely for neurologic changes.

Immediately report changes in skin
sensation and loss of muscle strength.
Either could point to pressure on the spinal
cord, possibly as a result of edema or
shifting bone fragments.

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 HEALTH
EDUCATION

• The need for isolation of

patients who can
potentially transmit the
disease is paramount.

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 HEALTH
EDUCATION

• In pediatric disease, the chances of

progression of deformity even years
after healing of the infection and
the need for regular follow-up until
skeletal maturity need to be clearly
communicated to the parents

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