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Revista de la Asociación Argentina de Ortopedia y Traumatología
On-line version ISSN 1852-7434
Abstract
MANZONE, Patricio et al. Mal de Pott en la provincia del Chaco. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2017, vol.82, n.3, pp.206-219. ISSN 1852-7434.
Introduction: Tuberculosis is the seventh leading cause of death. Spinal involvement represents <1% of cases. The objective was to investigate the frequency of Pott´s disease in our province, to typify its profile and to identify guidelines for similar regions. Methods: Identification of all tuberculosis admissions from 1996 to 2014 in the main referral hospitals of our province. Medical records review of all cases with spinal involvement. Frankel and GATA classifications. Data from last national census. Literature review. Results: Fourteen cases: 8 males/6 females. Average age: 35.4 years (range 3.8-63). Follow-up: 2.8 years (range 1 month- 15 years); one immediate postoperative death. Seven patients came from low tuberculosis burden Departments. Initial symptoms: neurological impairment (9 cases), pure axial and/or radicular pain (4 cases) and pure spine deformity (1 patient). Initial Frankel: E, 5 cases; D, 2; C, 2; and A, 5 patients. Localization: thoracic, 5; thoraco-lumbar, 6; lumbar, 1; multiple 2 patients. Ethnic distribution: 5 caucasians, 5 natives, 3 creoles, 1 mestizo. According to GATA classification: 1 type IB lesion; 4 type II; 8 type III; one unclassifiable case. Native patients had more severe neurological and GATA lesions. Twelve patients were operated on; 5 had residual deformities without differences among double instrumentation, isolated posterior instrumentation and no instrumentation. At follow-up: 8 asymptomatic cases, 4 deceased and 2 patients with moderate symptoms. No neurological worsening was observed; only 5 patients improved. Conclusions: Severe forms, and advanced and common surgical presentations are more frequent in native patients. Mortality is high.
Keywords : Tuberculosis; Pott’s disease.