A 34-year-old travelled to India seeking relief from escalating mid-back pain that had troubled him for a year, accompanied by malaise, decreased appetite, and weight loss. He consulted Dr. Hitesh Garg, Head of Ortho Spine Surgery at Artemis Hospital in Gurgaon.
A detailed clinical and radiological diagnosis revealed Pott’s spine, a form of tuberculosis affecting the vertebrae, despite the patient being on anti-tubercular treatment (ATT) for eight months.
He also exhibited a visible deformity in his mid-back and complained of dull, aching pain that worsened with movement. Examination and evaluation confirmed post-tubercular dorso-lumbar kyphosis, an abnormal curvature of the spine resulting from the disease. Dr. Garg recommended kyphosis correction surgery, which involved vertebrectomy (removal of the affected vertebral bodies), dorso-lumbar fixation, and fusion to stabilize the spine. The complex surgery was performed successfully.
Following a four-week recovery period in India, he was able to return to his country with significantly reduced pain, improved posture, and a renewed outlook.
Understanding Pott’s Spine
Pott’s disease, also known as tuberculous spondylitis, is a serious infection of the spine caused by Mycobacterium tuberculosis, the same bacteria responsible for pulmonary tuberculosis. While TB typically affects the lungs, it can spread to other parts of the body via the bloodstream, including the spine. In the spine, the infection often starts in the vertebral body, eventually spreading to adjacent vertebrae and intervertebral discs. This can lead to:
- Vertebral destruction: The bacteria erode the bones of the spine, causing them to weaken and collapse.
- Discitis: Inflammation and destruction of the intervertebral discs, which serve as cushions between the vertebrae.
- Kyphosis: The collapse of vertebrae leads to an abnormal curvature of the spine, resulting in a hunchback or kyphotic deformity.
- Abscess formation: Collections of pus (cold abscesses) can form around the spine, potentially compressing the spinal cord and nerves.
Consequences of Untreated Pott’s Spine
If Pott’s spine is not diagnosed and treated promptly, it can lead to severe and potentially irreversible complications, including:
Progressive deformity: The kyphosis can worsen over time, causing significant cosmetic disfigurement and functional limitations.
Chronic pain: Persistent and debilitating back pain can severely impact a person’s quality of life.
Compression of the spinal cord or nerve roots can result in:
- Weakness or paralysis of the limbs
- Numbness or sensory loss
- Bowel and bladder dysfunction
Spinal instability: The destruction of vertebrae can make the spine unstable, increasing the risk of further injury or collapse.
Spread of infection: In rare cases, the disease can spread to other parts of the body, leading to more widespread tuberculosis.
Early diagnosis and treatment with anti-tuberculosis medication are crucial to prevent these complications. Surgery may be necessary in cases with severe deformity, neurological involvement, or persistent pain, as in his case.