Experiences in management of Pott's paraplegia and paraparesis in medical wards of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

BACKGROUND

Pott's disease refers to spinal tuberculosis, which commonly leads to a gradual onset of neurological deficit that are difficult to diagnose at the early stage.

METHOD: The study was a combination of retrospective and prospective study. Information was obtained using a predesigned protocol. Diagnosis was based on clinical features and plain spinal x-ray. Anti-tuberculous therapy was instituted in all patients for a minimum of 18 months. Monitoring of neurological status was done weekly.

RESULTS

There were 92 patients made up of 71 males (77.2%) and 21 females (22.8%) with a male: female ratios of 3.4:1. 53.3% were paraplegic while 46.7% were paraparetic. The age group 31-40 years was the most affected. 43.5% of the patients were farmers who formed the majority. Back pain, weight loss, paraplegia and paraparesis in that order were the common clinical features. 25% of the patients recovered full use of their lower limbs at the end of the study. Thoracic spine and lumbar spine were equally involved (41.5% respectively) while thoraco-lumbar spine was involved in 15.1% of patients. Cervical spine was only involved in 1.9% of the patients.

CONCLUSION

Effective management of spinal tuberculosis should be a teamwork involving the physician, orthopedic surgeon, neurosurgeon as well as the radiologist. The rural populace needs to be educated to prevent late complications and ensure better prognosis.