Pott's disease: medical and surgical treatment.

OBJECTIVES

To evaluate the best treatment of Pott's disease.

MATERIALS AND METHODS

7 cases of Pott's disease were treated in the department of Neurosurgery of Sapienza University of Rome (Italy) between 2004 to 2011.

RESULTS

All patients underwent surgical drainage of abscess and vertebral stabilization. In all cases culture exam showed positivity after 40 days of incubation. After surgery for a period of one year chemotherapy was administered. In all cases MRI scan with gd of the spinal column were performed 12 months after surgery and no recurrence of disease has been shown.

DISCUSSION

Pott's disease is defined as vertebral involvement of extrapulmonary Tubercolosis (TB), involving mainly toraco-lumbar tract of the spine. MRI with gd represents the gold standard for the diagnosis. Treatment can be medical, surgical or usually both. The slippery course of the disease often causes a delay in getting to a diagnosis that is not made prior to rising signs, such as large abscess, neurological impairment or vertebral fractures. In these cases medical treatment alone did not show effective results, because no specific antibiotic drug can permeate the abscess's capsule, and an effective concentration is not achieved in the infection's site. Therefore, surgical treatment is necessary to abscess draining and setting the correct medical treatment to mycobacterial eradication.