• extraspinal source of infection and hematogenous dissemination.

Pott disease manifests as a combination of osteomyelitis and arthritis

that usually involves more than 1 vertebra. The anterior aspect of the
vertebral body adjacent to the subchondral plate is 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, the disk, because it is
vascularized, can be the primary site.
• Spinal TB accounts for 2% of all cases of TB, 15% of the cases of
extrapulmonary TB and 50% of the cases of skeletal TB.[1] Spinal TB is
usually secondary to lung or abdominal involvement and may also be
the rst manifestation of TB. Usually two continuous vertebrae are
involved but several vertebrae may be affected, skip lesions, and
solitary vertebral involvement may also be seen. The so called skip
lesion or a second lesion not contiguous with the more obvious
lesion is seen in 4‑10% of cases.[4‑9] Lower thoracic and lumbar
vertebrae are the most common sites of spinal TB followed by
middle thoracic and cervical vert
Ansari, et al.: Pott’s spine: Diagnostic imaging modalities and technology advancements
• incidence
• increasing incidence of TB in United States due to increasing
immunocompromised population
• demographics
• HIV positive population (often seen in patients with CD4+ count of 50 to 200)
• location
• 15% of patients with TB will have extrapulmonary involvement
• the spine, and specifically, the thoracic spine is the most common
extrapulmonary site
• 5% of all TB patients have spine involvement
Physical findings
• Localized Tenderness • fever
• Muscle Spasms • Night sweats
• Restricted Spinal Motion • Weight loss
• Spinal Deformity • Malaise
• Neurological Deficits
• Vertebral Fractures
• Vertebral Collapse
• Paralysis
• Avascularity of Intervertebral Discs
• Spinal Ligament Destruction
• Intervertebral Disc Destruction
• Abnormal Muscle Tone
• Paravertebral Abscess
• Osteopenia/Osteoporosis
• Bone Sequestrations
• Kyphotic Deformity
• Muscle Atrophy
• Torticollis
• Once the diagnosis of Pott disease is established and treatment is started, the duration of hospitalization
depends on the need for surgery and the clinical stability of the patient.
• While most patients should respond to medical treatment, a surgical approach needs to be evaluated and
considered. Indications for surgical treatment of Pott disease generally include the following: [52, 53]

• Neurologic deficit - Acute neurologic deterioration, paraparesis, and paraplegia

• Spinal deformity with instability or pain

• No response to medical therapy - Continuing progression of kyphosis or instability

• Large paraspinal abscess

• Nondiagnostic percutaneous needle biopsy sample

 • posterior stabilization with
instrumentation.

IMPRESSION:

Findings are suggestive of T8/T9 spondylitis with evidence of

epidural phlegmon and few pockets of collection in
perivertebral spa