In Pott's spine, the neurological deficit (Pott's paraplegia) occurring after many years of apparently healed disease is called 'late-onset paraplegia' or paraplegia of healed disease. The PRIMARY mechanism is:

• A Progressive kyphosis causing mechanical cord compression over bony ridge ✓
• B Reactivation of dormant tubercle bacilli compressing the cord
• C Epidural abscess that has become calcified
• D Arachnoiditis causing cord tethering

Explanation

Late-onset (healed disease) paraplegia occurs years after apparently successful treatment of Pott's spine. The primary mechanism is progressive kyphosis: as the vertebral bodies collapse, the posterior elements remain intact creating a sharp angular gibbus deformity. The spinal cord is draped over the posterior bony ridge at the apex of the kyphosis, causing mechanical compression — a 'internal bony bar.' Unlike active disease paraplegia (caused by granulation tissue, caseous material, or cold abscess — extradural compression), late paraplegia is bony/mechanical, requiring anterior decompression and fusion.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.