Pott’s Disease, also known as spinal tuberculosis, is a form of tuberculosis (TB) that affects the spine, particularly the vertebrae. Named after Percivall Pott, an English surgeon who first described the disease in the 18th century, it is one of the most dangerous forms of extrapulmonary TB. If not diagnosed and treated early, it can lead to permanent deformity, paralysis, or even death.

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 Pott's disease, MRI - Stock Image - M240/0492 - Science Photo Library


Here's a detailed blog post-style explanation of Pott’s Disease (Spinal Tuberculosis) for your blog:

Pott’s Disease (Spinal Tuberculosis) – Symptoms, Causes, and Treatment

Introduction:

What is Pott’s Disease?

Pott’s Disease is a tuberculous infection of the vertebral bones, usually involving the thoracic and lumbar spine. It is caused by Mycobacterium tuberculosis, the same bacteria responsible for pulmonary TB. The infection typically spreads from a primary TB site (often the lungs) to the spine via the bloodstream.

Causes and Risk Factors:

Cause:

  • Mycobacterium tuberculosis enters the spine through hematogenous spread from a primary focus (commonly the lungs).

Risk Factors:

  • Untreated or poorly treated pulmonary TB

  • HIV/AIDS and other immunocompromised states

  • Malnutrition

  • Living in TB-endemic areas

  • Crowded or unsanitary living conditions

  • Diabetes mellitus

  • Prolonged corticosteroid use

Commonly Affected Areas:

  • Thoracic spine (most common)

  • Lumbar spine

  • Cervical spine (rare)

  • Sacral spine (very rare)

Symptoms of Pott’s Disease:

Symptoms develop gradually and often go unnoticed in early stages. Common signs include:

Spinal Symptoms:

  • Persistent back pain (dull, localized)

  • Spinal stiffness

  • Localized tenderness

  • Gibbus deformity (angular kyphosis of the spine)

  • Difficulty in movement

Neurological Symptoms:

  • Numbness or weakness in limbs

  • Paraplegia (in advanced cases due to spinal cord compression)

  • Loss of bladder/bowel control (late stage)

Systemic Symptoms:

  • Low-grade fever

  • Night sweats

  • Weight loss

  • Fatigue

Complications:

  • Spinal cord compression

  • Kyphotic deformity (permanent humpback)

  • Paralysis

  • Abscess formation (cold abscess)

  • Vertebral collapse

Diagnosis:

Clinical Evaluation:

  • History of TB exposure or prior TB

  • Back pain not responding to usual treatment

Investigations:

  1. Imaging:

    • X-ray spine: Shows vertebral body destruction, collapse, and kyphosis.

    • MRI: Most sensitive tool to detect early changes and soft tissue abscesses.

    • CT scan: For bony detail and surgical planning.

  2. Lab Tests:

    • ESR and CRP: Usually elevated

    • Tuberculin skin test (Mantoux test)

    • Interferon-Gamma Release Assays (IGRA)

    • CBC: May show anemia or lymphocytosis

  3. Microbiological Confirmation:

    • Biopsy of vertebral tissue

    • AFB staining and culture

    • PCR for TB DNA

Treatment:

1. Medical Management:

  • Anti-Tuberculosis Therapy (ATT) is the cornerstone.

    • Intensive phase: 2 months (HRZE) – Isoniazid, Rifampicin, Pyrazinamide, Ethambutol

    • Continuation phase: 7–10 months (HR) – Isoniazid, Rifampicin

    • Total duration: 9 to 12 months

2. Surgical Treatment (if needed):

Indicated in:

  • Neurological deficits

  • Spinal instability

  • Abscess not responding to treatment

  • Severe kyphosis

Procedures may include:

  • Decompression

  • Spinal fusion

  • Abscess drainage

3. Supportive Care:

  • Bed rest (in early stages)

  • Spinal braces

  • Physiotherapy after initial healing

Prevention:

  • Early diagnosis and treatment of pulmonary TB

  • BCG vaccination

  • Screening high-risk populations

  • Improving sanitation and nutrition

Prognosis:

With timely and proper treatment, most patients recover well. However, if diagnosis is delayed or the disease progresses unchecked, it can lead to permanent neurological damage or deformity.

Conclusion:

Pott’s Disease is a serious but treatable form of extrapulmonary tuberculosis. Awareness and early detection are critical. If you or someone you know is experiencing persistent back pain, especially with TB symptoms, consult a doctor immediately. With modern diagnostics and anti-tubercular treatment, patients can recover and lead a normal life.

Disclaimer: This article is for educational purposes only and should not be used as a substitute for professional medical advice.

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