Pott's spine is commonest in spine -
Potts Spine * Tubercular spondylitis has been documented in ancient mummies from Egypt and Peru and is one of the oldest demonstrated disease.Percival Pott presented the classic description of spinal TB in 1779. * Spinal TB constitutes about 50% of all cases of osteoaicular TB. * MC site: Lower thoracic and lumber region followed by middle thoracic and cervical veebrae. Paradiscal * Commonest type * Spread through aerial supply * Bacteria lodge in the contiguous areas of two adjacent veebrae 4 granulomatous inflammation leading to erosion of veebral margins -loss of nutrition of interveebral disc -Disc degeneration * When the interveebral discs have been completely destroyed,the adjacent bodies fuse with each other. Central Lesions * Body of single veebra is affected. * Stas in the centre of the veebral body. * Infection at this site probably reaches through Batson&;s venous or branches of post.veebral ary. * Lytic area develops in the centre of veebral body leading to balooning of veebral body mimicking tumour * Later stages-concentric collapse resembling Verebra Plana. * Disc space is not/minimally affected Clinical Features * Constitutional symptoms,such as fever, night sweats,loss of weight and appetite may occur before symptoms related to spine. 1. Pain-can be -*Localised to the site(MC early symptoms) - Radicular -*worsen with activity and at night(night cries) 2. Stiffness -Protective mechanism of body where paraveebral muscle go into spasm to prevent movement at the affected veebra. 3. Cold abcess - Patient may present the first time with swelling(cold abcess) or due to its compression effects:- Retropharyngeal abscess --Dysphagia,dyspnea, Hoarseness of voice Mediastinal abscess --Dysphagia Psoas abscess -- Flexion deformity of hip -No usual signs of inflammation like heat ,redness etc. -Follows paths of least resistance along facial planes,blood vassels &nerves. REF :MAHESWARI 9TH ED
Cevical
Thoracic
Lumbar
Sacral
Skeletal infections