Abstract
Study design:
Spinal tuberculosis as all other osteoarticular tuberculosis occurs as a result of hematogenous dissemination of Mycobacterium tuberculosis from a primarily infected visceral focus mainly lungs, but Pott’s paraplegia occurring secondarily to Scrofuloderma has not been reported till date.
Purpose:
To document such an association of Pott’s paraplegia and Scrofuloderma.
Methods:
A 29-year-old female presented to us with low backache and paraplegia of 1 month duration. Clinical examination showed multiple healed Scrofuloderma lesions over sterum and neck (Figure 1). Magnetic resonance imaging (Figure 4), computed tomography (Figure 3) and X-ray (Figure 2) showed Pott’s spine involving dorsal vertebrae (D8–10) with pre and paravetebral abscess with intraspinal extension. She was treated by minimally invasive surgery to drain pus and granulation tissue by resecting transverse process of D9 vertebra. Drained material was sent for histopathological examination, Zielh-neelsen (ZN) staining, culture and sensitivity for M. tuberculosis. Patient completely recovered neurologically after 1 month of surgery.
Clinical photographs showing multiple healed Scrofuloderma lesions over neck and sternum.
X-ray dorso lumbar spine antero-posterior view showing lateral translation of D9 over D10 vertebra.
Results:
Patient completely recovered neurologically after surgery and is presently on multidrug chemotherapy and spinal brace.
Conclusions:
Pott’s paraplegia can occur secondary to Scrofuloderma and it can be managed by multidrug antitubercular therapy and minimally invasive surgical procedure.
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Kanojia, R., Kalra, M., Sareen, A. et al. Pott’s paraplegia secondary to Scrofuloderma is a rare association. Spinal Cord 51, 931–933 (2013). https://doi.org/10.1038/sc.2013.101
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DOI: https://doi.org/10.1038/sc.2013.101
