Pott's disease Classification: Difference between revisions
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===Based on the Onset of Paraplegia=== | ===Based on the Onset of Paraplegia=== | ||
====Early Paraplegia==== | ====Early Paraplegia==== | ||
*It develops in the [[active stage]] of [[tuberculosis]] [[infection]], commonly seen in adults within 2 years of [[infection]]. | *It develops in the [[active stage]] of [[tuberculosis]] [[infection]], commonly seen in adults within 2 years of [[infection]].<ref name="pmid27587940">{{cite journal| author=Aydın T, Taşpınar Ö, Keskin Y, Kepekçi M, Güneşer M, Çamlı A et al.| title=A Rare Complication of Tuberculosis: Acute Paraplegia. | journal=Ethiop J Health Sci | year= 2016 | volume= 26 | issue= 4 | pages= 405-7 | pmid=27587940 | doi= | pmc=4992782 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27587940 }} </ref> | ||
*The [[spinal cord]] compression is due to the pressure from the [[necrotic]] [[debris]] from the damaged [[bone]] and [[intervertebral disc]], [[pus]] and the [[granulation tissue]]. | *The [[spinal cord]] compression is due to the pressure from the [[necrotic]] [[debris]] from the damaged [[bone]] and [[intervertebral disc]], [[pus]] and the [[granulation tissue]]. | ||
*[[Spinal cord]] compression in [[Pott's disease|spinal tuberculosis]] can result from other causes causing [[compression]] such as [[subluxation]] and [[dislocation]] due to destruction of [[anterior column]], [[compression fracture]] as a result of wide spread [[infection]], spread of [[infection]] to the [[spinal cord]], [[arterial thrombosis]] and formation of a intra or [[extramedullary]] [[tuberculoma]] of the [[spinal cord]]. | *[[Spinal cord]] compression in [[Pott's disease|spinal tuberculosis]] can result from other causes causing [[compression]] such as [[subluxation]] and [[dislocation]] due to destruction of [[anterior column]], [[compression fracture]] as a result of wide spread [[infection]], spread of [[infection]] to the [[spinal cord]], [[arterial thrombosis]] and formation of a intra or [[extramedullary]] [[tuberculoma]] of the [[spinal cord]]. |
Revision as of 15:38, 27 March 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Classification
Paraplegia is classified into early and late paraplegia based on the activity of the tuberculous infection:
Based on the Onset of Paraplegia
Early Paraplegia
- It develops in the active stage of tuberculosis infection, commonly seen in adults within 2 years of infection.[1]
- The spinal cord compression is due to the pressure from the necrotic debris from the damaged bone and intervertebral disc, pus and the granulation tissue.
- Spinal cord compression in spinal tuberculosis can result from other causes causing compression such as subluxation and dislocation due to destruction of anterior column, compression fracture as a result of wide spread infection, spread of infection to the spinal cord, arterial thrombosis and formation of a intra or extramedullary tuberculoma of the spinal cord.
- Emergent treatment is warranted in patients presenting with early paraplegia.
Late Paraplegia
- It is a complication that develops in a patient with healed tuberculosis. The timing of presentation is variable and can occur 2 or 3 decades after the active infection. Typically it is defined as neurological symptoms appearing after 2years of primary infection.
Stages of Spinal tuberculosis
The following table describes the stages of spinal tuberculosis
Stage | Description | Imaging Findings | Duration |
---|---|---|---|
I | Stage of implantation, Incipient stage or Predestructive stage |
|
Less than 3 months |
II | Stage of early destruction | Diminished disc space, paradiskal erosion, kyphosis <10°( Kyphosis stage 1) | 2–4 months |
III | Stage of advanced destruction and collapse | 3–9 months | |
IV | Stage of neurological involvement | Stage III or IV with grade 4 paraplegia | Variable |
V | Stage of residual deformity and aftermath | Kyphosis stage 1 to 3, disease active locally grumbling, reactivated or healed | 3–5 years |