Pott’s Disease Manifestations:

♠ Back pain
Definition: ♠ Fever
Spine infection associated with tuberculosis that is characterized by bone ♠ Night sweating
destruction, fracture, and collapse of the vertebrae, resulting in kyphotic ♠ Anorexia
deformity. ♠ Weight loss
Other Names: ♠ Spinal mass, sometimes associated with numbness, tingling, or
Pott's Syndrome, Pott's Caries, Pott's Curvature, Angular Kyphosis, Kyphosis muscle weakness of the legs
secondary to Tuberculosis, Tuberculosis of the Spine, Tuberculous ♠ There may be kyphosis. (spinal curvature)
Spondylitis and David's Disease ♠ A paravertebral swelling may be seen.
Named after: ♠ They tend to assume a protective upright, stiff position.
Percivall Pott (1714–1788), a British surgeon who trained at St ♠ If there is neural involvement there will be neurological signs.
Bartholomew's Hospital, London. ♠ A psoas abscess (may present as a lump in the groin and resemble a
hernia).
Particularly Localized:
Pathognomonic Sign: Gibbus
Lower thoracic and the Upper lumbar regions are affected.
Formation

Most Commonly Localized:

Thoracic 11 and Thoracic 12.
Mode of Transmission:
Haematogenous spread of tuberculosis from other sites, often pulmonary.
Causative Agent:
Mycobacterium Tubercule
Immunization:
Patient with BCG vaccine has 80% immunity.

Risk Factors: Anatomy and

♠ Race - African Americans, Hispanic Americans, Asian Americans, Physiology:
and foreign-born individuals; Socioeconomic factors and historical The spinal cord is the
exposure to the infection. largest nerve in the body, and it is
♠ Sex – common on Males comprised of the nerves which act as the communication system for the body.
The nerve fibers within the spinal cord carry messages to and from the brain
Classifications: to other parts of the body. The spinal cord is surrounded by protective bone
segments, called the vertebral column. The vertebral column is comprised of
♠ Axial skeletal involvement/disorder
seven cervical vertebrae, twelve thoracic vertebrae, five lumbar vertebrae and
♠ Dorsal spine involvement/disorder five sacral vertebrae. The vertebral column also provides attachment points
♠ Lumbar spine involvement/disorder for muscles of the back and ribs. The vertebral disks serve as shock absorbers
♠ Lumbosacral joint involvement/disorder during activities such as walking, running and jumping, they also allow the
♠ Vertebra/Spine disorder spine to flex and extend.
 ♠ Erosion of bone.
♠ Fusiform paraspinal shadow of abscess in soft tissue.
Pathophysiology:
Pulmonary Tuberculosis Late:
↓ ♠ Destruction of bone.
Spread of Mycobacterium Tubercule in the T7-T9 of the spine
♠ Wedge-shaped deformity (collapse of vertebrae anteriorly).
↓
Extra-pulmonary Tuberculosis ♠ Bony ankylosis
↓ CT scan of the Thoracic Spine
The infection spreads from intervertebral disc Impression:
↓ Findings as consistent with Potts disease T8-T9 with pulmonary extension
Pus formation between the intervertebral disc as described
↓
Back Pain, Fever, Night Sweats, Spinal mass
↓ Managements
Disc tissue dies and broken down by caseation Medical:
↓ ♠ Immobilization using prolonged bed rest or body cast/splintage
Vertebral Narrowing
↓ ♠ Nutritious foods such as High Protein and High Carbo Diet
Vertebral Collapse ♠ Drainage of abscess
↓ Pharmacological:
Spinal Damage
♠ Chemotherapy for 6-9 months
↓
Potts’ Disease ♠ 4-drug regime/Ant-infectives
♠ Analgesics (Paracetamol)
Laboratory Test Surgical:
Blood ♠ Surgical Decompression
♠ TLC: Leucocytosis. Nursing Diagnosis:
♠ ESR: raised during acute stage. ♠ Acute pain related to inflammatory process
Tuberculin skin test ♠ Disturbed body image related to trauma/injury to spinal cord
♠ Strongly positive. ♠ Self – bathing hygiene deficit related to musculoskeletal impairment
♠ Negative test does not exclude diagnosis. ♠ Impaired physical mobility related to therapeutic restriction of
Aspirate from joint space & abscess movement
♠ Transparency: turbid. ♠ Imbalance nutrition related to inadequate food intake
♠ Colour: creamy. Nursing Responsibilities:
♠ Consistency: cheesy. ♠ Encourage intake of Vitamins to enhance patient food intake
♠ Fibrin clot: large. ♠ Encourage and Provide rest periods to conserve energy
♠ Mucin clot: poor. ♠ Provide oral care before and after meals to reduce bad taste from
♠ WBC: 25000/cc.mm. medications
♠ Encourage to change position every 2hours to avoid bed ulcers
Diagnostic Test ♠ Provide skin care to promote good hygiene
X-ray of the Thoracolumbar Spine ♠ Explain the use of adjunctive device such as Taylors/Knight Brace to
Impressions: promote knowledge and safety
Early:
♠ Narrowed joint space. Complications
♠ Diffuse vertebral osteoporosis adjacent to joint. ♠ Vertebral collapse resulting in kyphosis.
♠ Spinal cord compression.
♠ Sinus formation.
♠ Paraplegia (so called Pott's paraplegia)