Pott’s disease ( Pott’s curvature or Angular kyposis)

o Tuberculosis of the spine, the most common site of bone and joint tuberculosis. A progressive
destructive disease resulting from the activity of Mycobacterium tuberculosis in bone or articular
structures. It caused by infection in another part of the body, such as lungs or lymph nodes.
o It also called Tuberculous Spondylitis. It has been documented in ancient mummies from Egypt and
Peru and is one of the demonstrated diseases of humankind. Percival Pott presented the classic
description of spinal tuberculosis in 1779.
o Tuberculous involvement of the spine has the potential for serious morbidity, including permanent
neurological deficits and severe deformity.
o Medical treatment or combined medical and surgical strategies can control the disease in most
patients.
o Is a presentation of extrapulmonary TB that affects the spine.

Signs and symptoms: Diagnostic tools:

 Back pain  blood tests
 Fever  skin tests
 Night sweating  radiographs of the spine
 Anorexia  bone scan
 Weight loss  CT of the spine
 Spinal mass  bone biopsy

Complications  Pneumonia
 Spine Deformities  Bed sores
 Cold abscess  Constipation
 Paraplegia
ANATOMY

The spinal column is the center for control of our
posture and provides our stability when we stand.
It also allows for flexibility, so that we can do
different things such as stand or sit, stretch
backward or bend forward. We can even twist our
backs or necks one way or another. Because of its
many functions, the spine is very vulnerable to
injury – injuries can occur to the bones themselves,
the ligaments that connect the bones, discs that
separate each vertebral bone from one another, or
muscles that give movement to our spinal
skeleton.

PATHOPHYSIOLOGY

Pulmonary tuberculosis

Spread of mycobacterium tuberculosis from other site

Extrapulmomary tuberculosis

The infection spreads from two adjacent vertebrae into the adjoining disc space

back pain, fever, night sweats, anorexia, weight loss

One vertebra is affected, the disc is normal. Two are involved, the avascular intervertebral disc
cannot receive nutrients and collapse

Disk tissue dies and broken down by caseation

Vertebral narrowing

Vertebral collapse

Spinal damage

Nursing Diagnoses

 Pain
 Imbalanced nutrition, less than body requirements
 Risk for impaired skin integrity
 Risk for spread of infection
 Activity intolerance
 Impaired physical mobility
 Self care deficit
 Risk for constipation
 Anxiety
 Chronic low self-esteem
 Knowledge deficit

Nursing intervention

 Monitor vital sign

 Provide comfort measure
 Inspect skin for presence of cold abscess
 Increased fluid intake
 Check traction setup
 Promote deep breathing and coughing exercise
 Keep skin clean and dry
 Note emotional and behavioral responses to problem of immobility
 Encourage patient to express feelings
 Assist with physical therapy
 Administered multivitamins as indicated
 Provide a balanced diet of complex carbohydrates and ordered amount of high-quality protein and
essential amino acids.

Medical management

 non-operative - antituberculous drugs

 analgesics

Surgical mangement

 Surgery may be necessary, especially to drain spinal abscesses or to stabilize the spine
 Anterior Decompression and/or Fusion of the Spine

 Richards intramedullary hip screw - facilitating for bone healing

 Kuntcher Nail - intramedullary rod
 Austin Moore - intrameduallary rod (for Hemiarthroplasty)
 Taylor Brace

Discharge Plan

P- atient should be reminded to attend check ups at the nearest….

O- rthopedic center
T- reatment should be taken in a…..
T- imely manner
S- ight any symptoms other than the usual and report it to the physician