A patient with Pott's disease

Bilateral psoas abscesses are uncommon in Pott’s disease. We describe a 28-year-old Nigerian woman with a 2-year history of constitutional symptoms and a 1-year history of bilateral paravertebral masses. She had received anti-tuberculosis (TB) treatment in an interrupted manner. A computed tomography (CT) scan revealed T10–T12 spondylitis, wedge collapse and extensive bilateral psoas abscesses. Histology of the abscess wall was definitively diagnosed as soft tissue TB, and special staining for acid-fast bacilli was positive. She was successfully treated with anti-TB therapy and ultrasound-guided surgical drainage of 6 L of abscess fluid. Complicated cases of Pott’s disease may require multi-disciplinary interventions for optimal outcome.

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Ligamentum flavum hypertrophy in a patient with Pott’s disease

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh191201077a ◽

2020 ◽

pp. 77-77

Author(s):

Vuk Aleksic ◽

Rosanda Ilic ◽

Mihailo Milicevic ◽

Filip Milisavljevic ◽

Milos Jokovic

Keyword(s):

Spinal Cord ◽

Spinal Deformity ◽

Neurological Deficit ◽

Ligamentum Flavum ◽

Late Onset ◽

Spinal Canal Stenosis ◽

Pott’S Disease ◽

Canal Stenosis ◽

Common Causes ◽

Angular Kyphosis

Introduction. The spine is involved in less than 1% of all tuberculosis (TB) cases, and it is a very dangerous type of skeletal TB as it can be associated with neurologic deficit and even paraplegia due to compression of adjacent neural structures and significant spinal deformity. The spine TB is one of the most common causes for an angular kyphotic deformity of spine. Patients with 60 or more degree kyphosis at dorsolumbar spine are at great risk to develop late onset neurological deficit and paraplegia due to chronic compression and stretching of the spinal cord over bonny ridges. In small portion of cases other conditions may lead to neurological deficit in patients with long standing angular kyphosis which also alters the treatment strategy that otherwise involves prolonged and mutilant surgery. Case outline. We present a case of a 61-year-old male patient with concomitant 90-degree dorsolumbar spine kyphosis due to spinal TB and ligamentum flavum hypertrophy, which led to spinal canal stenosis with myelopathy and consequent paraplegia. The patient undergoes dorsal decompression with removal of the hypertrophic yellow ligament after which he recovered to the level of walking. Conclusion. Many authors propose guidelines for treatment of spinal TB taking into account the stage of the disease, the age of the patient, the angle of kyphosis, and other factors. We find that the best approach for each patient is personalized medical approach.

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