Abigail B.

Gamboa IV- Integrity

POTTS DISEASE
(TB Spondylitis, TB disc disease, vertebral collapse, Spinal TB, Spine deformity, Extra Pulmonary TB)

DEFINITION: Tuberculosis of the spine (Potts disease) is the most common site of the infection in TB. Hips and knees are also often affected. The lower thoracic and upper lumbar vertebrae are the areas of the spine most often affected. ETIOLOGIC AGENT: Mycobacterium Tuberculosis RISK FACTORS: 1. Race socio economic factors and history of infection 2. Sex more common to males 3. Age usually in adults CLINICAL MANIFESTATIONS: y y y y y y y y y y y Localized back pain Fever Night sweats Cold abscess Paraplegia Anorexia Weight loss Rigidity Deformity Stiffness Weakness of the lower limbs

POTTS DISEASE CAUSES: 1. Bone destruction 2. Deformity 3. Paraplegia

PATHOPHYSIOLOGY:

Risk Factors (race, sex, age) Causative Agent (Mycobacterium Tuberculosis) Invades our body through inhalation and droplets Pulmonary Tuberculosis Primary Infection Spread through blood sputum Spinal cord Infection spread from 2 adjacent vertebrae into the adjoining disc space 1. Vertebra is affected, Disc is normal 2. Vertebra is affected, which is avascular Cannot received nutrients Weakness Collapse Gibbous formation Disc tissue dies and broken down by cassation Spinal cord irritated, blockage Vertebral collapse Spinal damage Weakness, paresthesia, paralysis POTTS DISEASE

MEDICAL TREATMENT: 1. Drug treatment is generally sufficient for Potts disease, with spinal immobilization if required. 2. Surgery 3. Standard anti TB treatment is required 4. Administration of multivitamins as indicated. SURGICAL TREATMENT: 1. Spinal decompression and fusion with lumbotomy incision and laminectomy.

NURSING MANAGEMENT: 1. 2. 3. 4. 5. 6. 7. 8. 9. Monitor Vital signs Investigate pain Reposition in bed every 2 hours Inspect skin for the presence of cold abscess Keep skin clean and dry Monitor the food and fluid intake Promote deep breathing and coughing exercise Involve patient in diversional activities Instruct and assist with active and passive ROM exercise

COMPLICATIONS: 1. 2. 3. 4. 5. 6. 7. Vertebral collapse Spinal cord compression Sinus formation Paraplegia Spine deformities Bed sore Cold abscess