El Khattabi W, Aichane A, Moussali N, Riah A, Berrada Z, Afif H, Abdelouafi A, Bouayad Z
Service des Maladies Respiratoires, Hôpital 20 août, CHU Ibn Rochd, Casablanca, Maroc.
Rev Pneumol Clin. 2012 Oct;68(5):275-81. doi: 10.1016/j.pneumo.2012.06.004. Epub 2012 Aug 9.
Pott's disease or spinal tuberculosis is rare, but represents the most common form of osteo-articular tuberculosis in endemic countries.
[corrected] From January 2000 to December 2010, we collected 16 cases of Pott's disease. We analyzed clinical and radiological profile, means of confirmation and treatment.
Spinal and chest pain were the most frequent signs. Four patients had neurological signs. The diagnosis was made by the detection of bacillus in the pus of paravertebral abscess in six cases, by histological study of vertebral biopsy in five cases, biopsy of another associated lesion in one case and in front of radio-clinical arguments with good clinical evolution under antibacillary treatment in four cases. The antibacillary treatment associating four drugs was indicated and correctly followed by all patients. Surgical drainage was associated in five cases. The evolution was good in all cases.
Diagnosis of Pott's disease is late when there is no neurological sign. Imaging allows to make early diagnosis with MRI. Prognosis is good when treatment is started early.
波特病或脊柱结核较为罕见，但在结核病流行国家却是骨关节结核最常见的形式。
2000年1月至2010年12月，我们收集了16例波特病病例。我们分析了临床和放射学特征、确诊方法及治疗情况。
脊柱和胸痛是最常见的症状。4例患者有神经症状。6例通过检测椎旁脓肿脓液中的杆菌确诊，5例通过椎体活检的组织学研究确诊，1例通过另一相关病变的活检确诊，4例在抗结核治疗下临床症状良好演变的情况下，根据放射临床依据确诊。所有患者均采用四种药物联合抗结核治疗，并正确遵循治疗方案。5例患者进行了手术引流。所有病例病情演变良好。
无神经症状时，波特病的诊断往往较晚。磁共振成像（MRI）有助于早期诊断。早期开始治疗时预后良好。
