Abstract
Tuberculous spondylitis, also known as Pott’s disease, is due to infection of the spine by mycobacterium tuberculosis (MTB) leading to vertebral body and inter-vertebral disc destruction. It is the most common form of musculoskeletal tuberculosis most frequently affecting the thoracolumbar spine and is commoner in young people. Onset of this condition is insidious and its clinical presentation is non specific. However, Pott’s disease may be complicated by neurologic deficits including paraplegia or even quadriplegia, with huge health, economic and psychological burden. Following is a case report of Pott’s disease involving the cervical spine in a 33-year old farmer presenting unusually with paraplegia and a negative Mantoux test. It is reported because this very uncommon condition is highly treatable, and there is need for a raised index of suspicion in order to diagnose this condition early, thus limiting its complications. The role of MRI in diagnosis of Pott’s disease is also highlighted.
Highlights
Pott’s disease, known as tuberculous spondylitis, refers to vertebral body and inter-vertebral disc destruction by Mycobacterium tuberculosis (MTB) [1].Pott’s disease accounts for about 1% - 2% of all cases of TB [1]
Tuberculosis (TB) has existed for millennia and remains a major global health problem, ranking above HIV/AIDS as one of the leading causes of death from an infectious disease [5]. It is a common disease among developing countries and Nigeria ranks fourth among the 30 high burden countries with an estimated 10.4 million new TB cases in 2015, the majority (56%) were among men [3]
Pott’s disease is a major cause of non-traumatic paraplegia and its attendant economic repercussion among adults in many developing countries such as Nigeria where pulmonary TB is prevalent owing to poor nutrition and environmental sanitation [7]
Summary
Pott’s disease, known as tuberculous spondylitis, refers to vertebral body and inter-vertebral disc destruction by Mycobacterium tuberculosis (MTB) [1]. Constitutional symptoms (fever and weight loss) are common The onset of these symptoms is usually insidious with slow progression [1]. There is usually a slow collapse of one or usually more vertebral bodies, resulting in gibbus deformity [1]. Neurologic complication is the most dreaded and crippling aspect of spinal tuberculosis and occurs mainly due to late diagnosis and treatment [4]. This case is reported to raise awareness that, though cervical Pott’s disease is uncommon, it should always be considered during examination and to highlight the role of MRI in diagnosis
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