Evaluation of Pott's disease with computed tomography

Area of Science:

• Radiology
• Infectious Diseases
• Spinal Surgery

Background:

• Spinal tuberculosis (TB) is a significant cause of morbidity, particularly in endemic regions.
• Accurate diagnosis and staging are crucial for effective management.
• Computed tomography (CT) offers detailed anatomical visualization of spinal pathologies.

Purpose of the Study:

• To review the CT findings in culture-positive spinal tuberculosis.
• To correlate CT appearance with the extent and characteristics of spinal TB.
• To evaluate the utility of CT in diagnosing and assessing disease spread.

Main Methods:

• Retrospective review of eight culture-positive spinal tuberculosis cases.
• Analysis of CT scans for vertebral body involvement, paraspinal soft tissue extension, and epidural space compromise.
• Correlation of imaging findings with clinical presentation and microbiological confirmation.

Main Results:

• Seven of eight patients demonstrated paraspinal soft tissue involvement.
• Multilevel vertebral involvement was observed in five patients.
• Epidural extension causing neurological symptoms occurred in two patients, with extensive paraspinal spread in three.
• CT findings were suggestive of TB even when not initially suspected and showed unsuspected disease extension.

Conclusions:

• CT imaging is highly valuable in diagnosing spinal tuberculosis, especially when clinical suspicion is low.
• CT effectively delineates the extent of vertebral and paraspinal involvement, including epidural extension.
• CT aids in treatment planning by identifying disease spread and can assist in image-guided aspiration for diagnosis.