Conservative Management of Pott's Spine and Its Outcome: An Institute-Based Observational Study

Rahil Jiwani, Sourabh Ghosh, Shubham Giri

Abstract


Objective: To analyze the functional outcome of cases with Pott’s disease treated solely by antitubercular drugs.

Methods: This observational study was conducted at the Department of Orthopedics of a tertiary care medical college. Sixty patients with Pott’s disease were included in this study based on predefined inclusion and exclusion criteria. All patients received antitubercular drugs for nine months. The Modified McCormick Scale (MSS) was used to assess the outcome of patients.

Results: Out of 60 patients, 37 (61.67%) were females, and 23 (38.33%) were males, with an M: F ratio of 1:0.62. Most patients had some or the other risk factors and belonged to low socioeconomic status. The most common presenting complaint was low back pain, and the thoracolumbar spine was most commonly involved. There was a significant improvement in the patient’s functional status as assessed by the MSS score.

Conclusion: If diagnosed early, patients with Pott’s disease can be treated solely by antitubercular treatment with excellent outcomes.


Keywords


Functional Outcome; McCormick Scale; Pott’s Disease; Tuberculous Spondylitis.

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References


  1. Rajasekaran S, Soundararajan DCR, Shetty AP, Kanna RM. Spinal tuberculosis: current concepts. global spine J. 2018; 8(4 Suppl):96S–108S. doi:10.1177/2192568218769053
  2. Ansari S, Amanullah MF, Ahmad K, Rauniyar RK. Pott’s Spine: diagnostic imaging modalities and technology advancements. N Am J Med Sci. 2013;5(7):404–11. doi:10.4103/1947-2714.115775
  3. Ayele BA, Wako A, Tadesse J, Gulelat H, Ibrahim R, Molla S, et al. Pott’s paraplegia and role of neuroimaging in resource limited setting: A case report and brief review of the literatures. J Clin Tuberc Other Mycobact Dis. 2021;25:100283. doi:10.1016/j.jctube.2021.100283.
  4. Misra UK, Warrier S, Kalita J, Kumar S. MRI findings in pott’s spine and correlating clinical progress with radiological findings. Neuroradiol. 2020;62(7):825–32. doi: 10.1007/s00234-020-02402-2
  5. Patel PD, Canseco JA, Houlihan N, Gabay A, Grasso G, Vaccaro AR. Overview of minimally invasive spine surgery. World Neurosurg. 2020;142:43-56. doi:10.1016/j.wneu.2020.06.043
  6. Rajasekaran S, Soundararajan DCR, Shetty AP, Kanna RM. Spinal tuberculosis: current concepts. global spine J. 2018; 8(4 Suppl):96S–108S. doi:10.1177/2192568218769053
  7. Ansari S, Amanullah MF, Ahmad K, Rauniyar RK. Pott’s spine: diagnostic imaging modalities and technology advancements. N Am J Med Sci. 2013; 5(7):404–11. doi:10.4103/1947-2714.115775
  8. Ayele BA, Wako A, Tadesse J, Gulelat H, Ibrahim R, Molla S, et al. Pott’s paraplegia and role of neuroimaging in resource limited setting: a case report and brief review of the literatures. J Clin Tuberc Other Mycobact Dis. 2021;25:100283. doi:10.1016/j.jctube.2021.100283.
  9. Misra UK, Warrier S, Kalita J, Kumar S. MRI findings in Pott’s spine and correlating clinical progress with radiological findings. Neuroradiology. 2020; 62(7):825–32. doi:10.1007/s00234-020-02402-2
  10. Patel PD, Canseco JA, Houlihan N, Gabay A, Grasso G, Vaccaro AR. Overview of minimally invasive spine surgery. World Neurosurg. 2020; 142:43–56. doi:10.1016/j.wneu.2020.06.043
  11. Bellut D, Burkhardt JK, Mannion AF, Porchet F. Assessment of outcome in patients undergoing surgery for intradural spinal tumor using the multidimensional patient-rated Core Outcome Measures Index and the modified McCormick Scale. Neurosurg Focus. 2015;39(2):E2. doi:10.3171/2015.5.FOCUS15163
  12. Jagiasi JD, Patel MR. Results of management of spinal tuberculosis according to middle path regime and short course chemotherapy. Int J Res Orthop. 2017;3:966–72. http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20173672
  13. Kothari MK, Shah KC, Tikoo A, Nene AM. Surgical management in elderly patients with tuberculous spondylodiscitis: ten year mortality audit study. Asian Spine J. 2016;10(5):915–9. doi:10.4184/asj.2016.10.5.915.
  14. Peer V, Schwartz N, Green MS. Gender differences in tuberculosis incidence rates-A pooled analysis of data from seven high-income countries by age group and time period. Front Public Health. 2023;10:997025. doi: 10.3389/fpubh.2022.997025.
  15. Wang P, Liao W, Cao G, Jiang Y, Rao J, Yang Y. Characteristics and management of spinal tuberculosis in tuberculosis endemic area of Guizhou Province: a retrospective study of 597 patients in a Teaching Hospital. Biomed Res Int. 2020;2020:1468457. doi:10.1155/ 2020/1468457
  16. Divya A, Shukla DP, Bahubali VH, Bharath RD, Nandeesh BN, Kruthika P, et al. Consumption of spine by tuberculosis in the era of directly observed treatment, short-course and genomic diagnosis. Indian J Tuberc. 2021;68(1):73–9. doi:10.1016/j.ijtb.2020.08.017.
  17. Mittal S, Yadav G, Ahuja K, Ifthekar S, Sarkar B, Kandwal P. Predicting neurological deficit in patients with spinal tuberculosis-A single-center retrospective case-control study. SICOT J. 2021;7:7. doi:10.1051/sicotj/2021002.
  18. Vaishnav B, Suthar N, Shaikh S, Tambile R. Clinical study of spinal tuberculosis presenting with neuro-deficits in Western India. Indian J Tuberc. 2019;66(1):81–6. doi:10.1016/j.ijtb.2018.04.009
  19. Jurcev-Savicevic A, Mulic R, Ban B, et al. Risk factors for pulmonary tuberculosis in Croatia: a matched case-control study. BMC Public Health. 2013;13:991. doi:10.1186/1471-2458-13-991
  20. Glassman I, Nguyen KH, Giess J, Alcantara C, Booth M, Venketaraman V. Pathogenesis, diagnostic challenges, and risk factors of pott’s disease. Clin Pract. 2023;13(1):155–65. doi: 10.3390/clinpract13010014.
  21. Misra UK, Warrier S, Kalita J, Kumar S. MRI findings in Pott’s spine and correlating clinical progress with radiological findings. Neuroradiology. 2020;62(7):825–32. doi: 10.1007/s00234-020-02402-2.
  22. Rivas-Garcia A, Sarria-Estrada S, Torrents-Odin C, Casas-Gomila L, Franquet E. Imaging findings of Pott’s disease. Eur Spine J. 2013;22 Suppl 4(Suppl 4):567–78. doi:10.1007/s00586-012-2333-9
  23. Kubihal V, Sharma R, Krishna Kumar RG, Chandrashekhara SH, Garg R. Imaging update in spinal tuberculosis. J Clin Orthop Trauma. 2021; 25:101742. doi:10.1016/j.jcot.2021.101742
  24. Talebzadeh AT, Talebzadeh N. Diagnosis, management, and prognosis of spinal tuberculosis: a case report. Cureus. 2023;15(2):e35262. doi:10.7759/cureus. 35262
  25. Kumar K. Spinal tuberculosis, natural history of disease, classifications and principles of management with historical perspective. Eur J Orthop Surg Traumatol. 2016;26(6):551–58. doi:10.1007/s00590-016-1811-x




DOI: https://doi.org/10.15850/ijihs.v11n2.3512

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