Tuberculous spondylitis - Pott disease

Tuberculous spondylitis (also known as Pott disease) is one of the oldest demonstrated diseases of humankind. In 1779 Percivall first described Pott's disease spinal tuberculosis. Since the discovery antituberculostaticelor and improving public health, spinal tuberculosis has become rare in developed countries, while still significant in developing ones. Affecting tuberculous column shows the potential to cause significant morbidity, including severe neurological deficits and spinal deformity.Pott's disease is the most dangerous form of musculoskeletal tuberculosis because it can cause destruction, deformity and paraplegia. Pott's disease affects mainly the thoracic and lumbar column. Affects the lower thoracic vertebrae are frequently followed by the lumbar spine. 10% of cases involve the cervical spine.
Tuberculous spondylitis, also called David's disease and Pott's shows like disease in clinical back pain, night sweats, fever, weight loss and anorexia. Patients may also develop a spinal mass with paresthesia, tremor, general weakness or tingling in the legs. Often the pain associated with Pott's disease cause a stuck position and went straight.
Tuberculostatics tuberculous spondylitis should be treated with for 6-9 months. Isoniazid and rifampicin should be administered throughout therapy. Additional drugs are administered in the first two months. These include pyrazinamide, ethambutol and streptomycin. Using second-line drugs is indicated in case of resistance.Lozalizarea lesion expansion and destruction of this compression spinal cord or spinal deformity determine specific Interventional Approach. Vertebral destruction is considered significant when 50% of the vertebral body is collapsed or destroyed or there is a spinal deformity more than 5 degrees.Compliance to therapy and drug resistance are additional factors that significantly affect the patient's evolution. Paraplegia by medullary compression determining active disease responds well to chemotherapy. If medical therapy does not cause a rapid improvement, interventional decompression increases the rate of recovery. Paraplegia can occur or persist during the healing spinal injuries due to permanent.
Tuberculous spondylitis - PathogenesisBorn to Pott's is usually a secondary source of infection extraspinale. The basic lesion is a combination of osteomyelitis and arthritis that affects more than one vertebra. Tuberculosis can spread to the adjacent intervertebral discs. Disc disease in adults is secondary infection from the vertebral body enlargement. In children the disc is vascularized and may represent the primary source.Progressive bone destruction leads to vertebral collapse and kyphosis. The spinal canal can be collapsed by abscesses, granulation tissue or direct dural invasion leading to spinal cord compression and neurological deficits. Cifotica deformation is caused by the collapse of the previous column. Injuries frequently result from thoracic spine to those of lumbar kyphosis. A cold abscess may develop if the infection extends to adjacent ligaments and soft tissues. Abscesses in the lumbar region can coborii until the psoas sheath femoral triangle and even erode the skin.