Pathophysiology

Pott disease is usually secondary to an extraspinal source of infection. The basic lesion
involved in Pott disease is a combination of osteomyelitis and arthritis that usually
involves more than one vertebra. The anterior aspect of the vertebral body adjacent to the
subchondral plate is area usually affected. Tuberculosis may spread from that area to
adjacent intervertebral disks. In adults, disk disease is secondary to the spread of
infection from the vertebral body. In children, because the disk is vascularized, it can be a
primary site.3

Progressive bone destruction leads to vertebral collapse and kyphosis. The spinal canal
can be narrowed by abscesses, granulation tissue, or direct dural invasion, leading to
spinal cord compression and neurologic deficits. The kyphotic deformity is caused by
collapse in the anterior spine. Lesions in the thoracic spine are more likely to lead to
kyphosis than those in the lumbar spine. A cold abscess can occur if the infection extends
to adjacent ligaments and soft tissues. Abscesses in the lumbar region may descend down
the sheath of the psoas to the femoral trigone region and eventually erode into the skin.

Introduction
Potts disease
 Is a spine infection associated with tuberculosis that is characterized by bone
destruction, fracture, and collapse of the vertebrae, resulting in kyphotic
deformity.

 Is the presentation of the extra-pulmonary tuberculosis arthritis of the

intervertebral joints

 Also called tuberculosis spondylitis, tuberculous spondyloarthropathy, spinal

TB, musculoskeletal tuberculosis

 The causative agent is Mycobacterium Tubercule

 Particularly the lower thoracic and the upper lumbar regions are affected.

 Commonly localized in the thoracic 11 and thoracic 12.

 The original name was formed after Percivall Potts a London surgeon.

 Patient with BCG has 80% immunity.

 Pathognomonic Sign: Gibbus Formation

 Signs and Symptoms: Back Pain, Fever, Night Sweating, Anorexia, Weight Loss,
Spinal mass, sometimes associated with numbness, tingling, or muscle weakness
of the legs
  Diagnostic Exam: Blood Test: elevated erythrocyte sedimentation rate,
Tuberculin test, Bone Scan, Radiographs of the spine, CT of the spine, Bone
biopsy, MRI

 Predisposing Factors: Direct contaminant especially in children, Malnutrition,

Poor Environmental Condition, Trauma

Pathophysiology
Pulmonary Tuberculosis
Spread of
Mycobacterium
Tubercule in the T7-T9
of the spine
Extra-pulmonary
Tuberculosis

The infection spreads

from intervertebral disc

Pus formation between

the intervertebral disc

Back Pain, Fever, Night

Sweats, Spinal mass

Disc tissue dies and

broken down by
caseation

Vertebral Narrowing

Vertebral Collapse

Spinal Damage

Potts’ Disease