Definition Pott’s disease is a presentation of extrapulmonarytuberculosis that affects the spine, a kind of tuberculous arthritis of the intervertebral joints. It is named after Percivall Pott (1714-1788), a London surgeon who trained at Barts. Scientifically, it is called tuberculousspond ylitis and it is most commonly localized in the thoracic portion of the spine. AKA: Pott’s syndrome, Pott’s caries, Pott’s curvature, angular kyphosis, kyphosis secondary to tuberculosis, tuberculosis of the spine, tuberculous spondylitis and David’s disease.
Anatomy: The vertebral column provides structural support for the trunk and surrounds and protects the spinal cord. The vertebral column also provides attachment points for the muscles of the back and ribs. The vertebral disks serve as shock absorbers during activities such as walking, running, and jumping. They also allow the spine to flex and extend. Pathophysiology: Pulmonary tuberculosis| | Spread of mycobacterium tuberculosis from other| | Extrapulmonary Tuberculosis| | The infection spreads from two adjacent vertebraeinto the adjoining disc space| | Back pain, Fever, Night sweats, Anorexia, Weight loss, and easy| |.
One vertebra is affected, the disc is normalTwo are involved; the avascular intervertebral disc cannotreceive nutrients and collapse| | Disk tissue dies and broken down by| | Vertebral narrowing| | Vertebral collapse| | Spinal damage| | POTT’S DISEASE| | Kyphosis,paraplegia, bowel and urinary incontinenece| | Surgery: evacuation of pus, Anteriordecompression spinal fusion| Signs and symptoms: The earliest and most common symptom of Potts disease is back pain. As the disease progresses, fever, night sweats, lack of appetite and weight loss occur. The person may experience tingling, numbness and weakness in the legs.
Diagnostic & Laboratory: Blood Test: elevated erythrocyte sedimentation rate, Tuberculin test, Bone Scan, Radiographs of the spine, CT of the spine, Bone biopsy, MRI Medical/Surgical Management of Pott’s disease Drug treatment is generally sufficient for Pott’s disease, with spinal immobilization if required. Surgery is required if there is spinal deformity or neurological signs of spinal cord compression. Standard antituberculosis treatment is required. Duration of antituberculosis treatment: If debridement and fusion with bone grafting are performed, treatment can be for six months.
If debridement and fusion with bone grafting are NOT performed a minimum of 12 months’ treatment is required. It may also be necessary to immobilize the area of the spine affected by the disease, or the person may need to undergo surgery in order to drain any abscesses that may have formed or to stabilize the spine. Management of Pott’s disease Drug treatment is generally sufficient for Pott’s disease, with spinal immobilization if required. Surgery is required if there is spinal deformity or neurological signs of spinal cord compression. Standard antituberculosis treatment is required.
Duration of antituberculosis treatment: If debridement and fusion with bone grafting are performed, treatment can be for six months. If debridement and fusion with bone grafting are NOT performed a minimum of 12 months’ treatment is required. It may also be necessary to immobilize the area of the spine affected by the disease, or the person may need to undergo surgery in order to drain any abscesses that may have formed or to stabilize the spine. Nursing Intervention: Independent: • Investigate report of pain, noting characteristics, location, intensity (0-10 scale). • Provide firm mattress and small pillows.
• Suggest patient assume position of proper comfort while in bed or chair. Promote bed rest as indicated. • Encourage frequent changes of position. • Apply warm or moist compress on the affected area several times a day. • Provide gentle massage. • Encourage use of stress management techniques. Collaborative: • Administer non steroidal anti- inflammatory drugs as prescribed. • Administer anti-biotic as prescribed. | • Helpful in determining pain management needs and effectiveness of the program. • Soft or sagging mattress and large pillows inhibits the proper body alignment.
• In acute phase, total bed rest may be necessary to limit pain. • Prevents general fatigue and joint stiffness. • Heat promotes muscle relaxation and mobility, decreases pain and relieves morning stiffness. • Promotes relaxation and reduces muscle tension. • Promotes relaxation, provides sense of control and may enhance coping activities. • These drugs control mild to moderate pain and inflammation by inhibition of prostaglandin synthesis. • To prevent further infection. | Pott’s Disease STI Global City College Of Nursing By: Rizza Jane Quijano Camille S. Protasio.