Pott's Spine: Retrospective Analysis of MRI Scans of 70 Cases

Tuberculosis is the commonest of the infections world wide and it can affect almost any part of the body, most commonly the thorax. The spine is affected in 50 % of the cases of skeletal tuberculosis. A tuberculous infection of the spine causes a bony destruction and collapse of the vertebrae, with a gibbus deformity, skip lesions, an intervertebral disc involvement, an epidural abscess, a paravertebral abscess and oedema in the soft tissue planes. Magnetic Resonance Imaging (MRI) is the most valuable investigation in the patients with spinal tuberculosis, as it can clearly demonstrate all of the above findings.

In this study, the MRI scans of 70 known cases of tuberculosis of the spine, which were done in the Department of Radiodiagnosis, R.D.Gardi Medical College, Ujjain, India, were retrospectively analyzed, to determine the pattern of occurrence of various pathological lesions.

It was found in this study, that Pott's spine was most commonly observed in the 21-50 years age group, with a male predominance. The dorsal and the lumbar vertebrae are commonly involved and multiple vertebrae were often affected, the L3 vertebra being the commonest. An intervertebral disc involvement and pre and paravertebral collections were commonly seen, with an epidural collection occurring in more than 75 % of the cases. Cord oedema was noted in 10% of the cases.

The MRI scan is highly sensitive in the detection of various pathological processes of Pott's spine and the patterns of occurrence of these findings were analyzed in this study. Since the incidence and prevalence of tuberculosis are dependent on various epidemiologically sensitive parameters, this study can provide a benchmark, against which the results of studies which will be done in the future can be compared.