POTT'S SPINE MANIFESTING AS PARAPLEGIA IN PREGNANCY AND ITS MANAGEMENT: A CASE REPORT

Abstract

Tuberculosis is a major health concern in India with extra- pulmonary presentation being 66.6% in pregnancy . Spinal TB or Pott's Spine in pregnancy is a rare entity which can lead to paraplegia and adverse feto-maternal outcomes. Our patient presented at 34+4 weeks POG with bilateral lower limb weakness and backache since 28weeks period of gestation. Paraparesis being an uncommon complaint in pregnancy, has varied etiology which involves spinal cord. Common causes include traumatic fracture injury, spinal cord compression due to tumor, metastasis, spinal TB, Pyogenic abscess and Transverse myelitis, Polio, Guillain-Barré syndrome (GBS), amyotrophic lateral sclerosis and Syringomyelia being the less common. The history, neurological examination and imaging helps in narrowing the diagnosis. In Pott's Spine, lower thoracic and upper lumbar region are affected the most. WHO recommends 6 months of therapy with intensive phase of 2 months and continuation phase of 4 months which can be prolonged to 12 – 18 months based on symptoms and imaging. Pott's Spine with neurological decits or those who show progressive decit even on ATT needs surgery. MRI is ideal in such a condition and prognosis is good with early decompression surgery with ATT.