A 30-year-old man presents with painless progressive kyphosis of the thoracic spine with bilateral lower limb weakness and spasticity. MRI shows destruction of T8–T9 vertebrae with a large anterior paraspinal cold abscess and cord compression. This condition is termed:

• A Pyogenic vertebral osteomyelitis with epidural abscess
• B Multiple myeloma with vertebral collapse
• C Pott's spine with Pott's paraplegia ✓
• D Metastatic carcinoma with pathological fracture

Explanation

Tuberculous spondylitis (Pott's spine) classically involves the anterior part of vertebral bodies and disc, producing anterior wedging and kyphosis (gibbus). A cold (psoas) abscess forms beneath the anterior longitudinal ligament and tracks along fascial planes. Cord compression in Pott's paraplegia may be due to mechanical pressure from abscess or caseous material, or later from fibrous tissue and bony collapse. MRI is the imaging of choice for cord assessment.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.