In Pott's disease (spinal tuberculosis), which neurological complication can develop decades after apparent clinical cure of the infection?

• A Paraplegia of healing (late-onset spinal cord compression from fibrosis, calcification, or mechanical kyphosis deformity) ✓
• B Paraplegia of disease (spastic paraplegia from ongoing infection and abscess)
• C Acute myelopathy from haematogenous seeding
• D Cauda equina syndrome from disc prolapse

Explanation

Paraplegia of healing (Hodgson's classification) occurs in patients who have recovered from active Pott's disease — years to decades later, progressive kyphosis causes mechanical stretch of the cord over the deformed kyphotic apex, or calcified fibrotic tissue compresses the cord in the absence of active infection. This is distinct from paraplegia of disease (active cold abscess/granulation tissue compressing cord). Treatment requires correction of the kyphosis (anterior decompression and fusion) rather than anti-TB drugs.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.