Pott's Disease with Paraparesis

Brian A. Shaw, M.D.

N Engl J Med 1996; 334:958-959April 11, 1996

Slide

Article

Figure 1 A 13-year-old boy presented with increasing kyphotic deformity, back pain, and progressive paraparesis seven years after a one-year course of medical therapy for tuberculosis. He reported shock-like sensations in his legs whenever he bent forward and fatigue in his thighs and calves, which limited his activities. Physical findings included a rigid gibbus (Panel A, arrow), inability to tiptoe, hyperreflexia of the ankles with mild clonus, and normal proprioception and sensation to light touch. A magnetic resonance imaging scan (Panel C) showed that the bodies of T9 through L1 had collapsed into one mass, compressing the spinal cord to about half its usual diameter (large arrow) and kinking his aorta (small arrow). He underwent a single operative procedure including anterior decompression and vertebrectomy with strut grafting with autologous iliac bone and rib (Panel D, arrow) followed by posterior spinal instrumentation and fusion. Histologic examination and culture showed no active tuberculous disease, and no further medical treatment was given. As of the most recent follow-up three years later (Panel B), he had made a complete neurologic recovery and was participating in all noncontact sports at his high school.

Kim Eagle, M.D.

Brian A. Shaw, M.D.
Valley Children's Hospital, Fresno, CA 93703

Citing Articles (1)

Citing Articles

1
Bülent Özbay, Kürşat Uzun. (2002) Extrapulmonary tuberculosis in high prevalence of tuberculosis and low prevalence of HIV. Clinics in Chest Medicine 23:2, 351-354
CrossRef