In Pott's spine with Frankel Grade C neurological deficit (incomplete motor function preserved), which of the following is the IMMEDIATE management priority?
- A Anti-TB chemotherapy for 6 months before any surgery
- B Posterior laminectomy to decompress the cord
- C MRI assessment followed by anterior decompression and spinal fusion ✓
- D Methylprednisolone protocol (as in acute SCI)
Explanation
A patient with Frankel Grade C (or ASIA C) neurological deficit from Pott's spine represents an urgent surgical indication. The compression is anterior (vertebral body collapse, pus, caseous material compressing the cord from the front); posterior laminectomy alone is contraindicated because it does not address anterior compression and may destabilize the spine further. The correct procedure is anterior decompression (debridement of diseased tissue) + bone grafting ± stabilization, ideally combined with anti-TB chemotherapy. Steroids are not standard in TB-related cord compression. Anti-TB therapy alone is appropriate only for patients with no or stable neurological deficit.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.