• The spine is the commonest site of bone and joint tuberculosis.
  • Dorso-lumbar region affected most frequently.

Types of vertebral tuberculosis:

1. Paradiscal: commonest type

2. Central:

  • Single vertebra is affected.
  • This leads to early collapse of the weakened vertebra.
  • The nearby disc may be normal.
  • The collapse may be a ‘wedging’ or ‘concertina’ collapse 

 3. Anterior:

  • infection is localised to the anterior part of the vertebral body.

 4. Posterior:

  • the posterior complex of the vertebra i.e., the pedicle, lamina, spinous process and transverse process are affected.


  • Pain (back pain)
  • Stiffness
  • Cold abscess
  • Paraplegia
  • Deformity: increasing prominence of the spine – gibbus.
  • Constitutional symptoms: Symptoms like fever, weight loss etc.


X-ray examination:

  • Reduction of disc space: earliest sign  
  • Destruction of the vertebral body 

Evidence of cold abscess:

1). Para-vertebral abscess-

  1. fusiform para-vertebral abscess (bird nest abscess – an abscess whose length is greater than its width (Fig-23.7a);
  2. globular or tense abscess – an abscess whose width is greater than the length

2). Widened mediastinum-

3). Retro-pharyngeal abscess

4). Psoas abscess

  • Rarefaction: diffuse rarefaction of the vertebrae above and below the lesion.
  • Unusual signs: erosion of the posterior elements of pedicle, lamina etc.
  • Signs of healing

CT scan:

  • very useful investigation in cases presenting as ‘spinal tumour syndrome’.


  • Investigation of choice to evaluate the type and extent of compression of the cord.

Other investigations:

  • ESR, Mantoux test, ELISA test for detecting anti- tubercular antibodies, chest X-ray, etc.,


  1. Cold abscess:  commonest complication of TB of the spine.
  2. Neurological compression: At times the patient presents as a case of spinal tumour syndrome.
  • First clinical symptom being a neurological deficit.

Exam Important

  • Tuberculosis in Pott’s disease involves Spine.
  • Pott’s spine is commonest at Thoracolumbar spine.
  • Tuberculosis of spine is common at Thoracolumbar.
  • Most common cause of cold abscess of chest wall is Pott’s spine.
  • Commonest presenting symptom of Pott’s spine is Back pain.
  • The paradiscal type is M/C type of vertebral tuberculosis.
  • Wedging or Concertina collapse: in central type.
  • Pott’s disease: M/C cause for kyphosis & cold abscess.
  • Earliest radiological sign of spine tuberculosis is reduction of intervertebral disc space.
  • M/C complication of spine tuberculosis cold abscess.
  • Investigation of choice- MRI.
  • M/c performed surgery- Antero lateral decompression.
  • TB of spine à bony ankylosis, other bones & joints a fibrous ankylosis.
Don’t Forget to Solve all the previous Year Question asked on TUBERCULOSIS OF SPINE (Pott’s disease)

Module Below Start Quiz

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this:
Malcare WordPress Security