Which finding at presentation carries the worst prognosis for development of severe progressive kyphosis in a child with spinal tuberculosis?

• A Isolated involvement of a single vertebral body
• B Disease confined to the posterior elements
• C Age below 7 years with destruction of three or more contiguous vertebral bodies ✓
• D Presence of a large paravertebral cold abscess

Explanation

Young children have growth cartilage in the anterior vertebral bodies, so destruction of multiple adjacent vertebrae before skeletal maturity leads to asymmetric growth arrest and buckling collapse, producing severe kyphosis that can worsen even after the infection heals. Posterior element disease and isolated single body involvement spare the anterior growth centres, and a cold abscess reflects active disease rather than the mechanical substrate for progressive collapse.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.