@article{3167510,
    title = "The course of spinal tuberculosis (Pott disease): results of the
multinational, multicentre Backbone-2 study",
    author = "Batirel, A. and Erdem, H. and Sengoz, G. and Pehlivanoglu, F. and and Ramosaco, E. and Gulsun, S. and Tekin, R. and Mete, B. and Balkan, I. I. and and Sevgi, D. Y. and Giannitsioti, E. and Fragou, A. and Kaya, S. and and Cetin, B. and Oktenoglu, T. and Celik, A. D. and Karaca, B. and Horasan, and E. S. and Ulug, M. and Senbayrak, S. and Kaya, S. and Arslanalp, E. and and Hasbun, R. and Ates-Guler, S. and Willke, A. and Senol, S. and Inan, D. and and Guclu, E. and Ertem, G. T. and Koc, M. M. and Tasbakan, M. and Ocal, and G. and Kocagoz, S. and Kusoglu, H. and Guven, T. and Baran, A. I. and and Dede, B. and Karadag, F. Y. and Yilmaz, H. and Aslan, G. and Al-Gallad, and D. A. and Cesur, S. and El-Sokkary, R. and Sirmatel, F. and Savasci, U. and and Karaahmetoglu, G. and Vahaboglu, H.",
    journal = "Clinical Microbiology and Infection",
    year = "2015",
    volume = "21",
    number = "11",
    publisher = "Elsevier Sci Ltd, Exeter, United Kingdom",
    issn = "1198-743X",
    doi = "10.1016/j.cmi.2015.07.013",
    keywords = "Pott disease; spinal tuberculosis; spondylitis; spondylodiscitis;
vertebral osteomyelitis",
    abstract = "We aimed to describe clinical, laboratory, diagnostic and therapeutic
features of spinal tuberculosis (ST), also known as Pott disease. A
total of 314 patients with ST from 35 centres in Turkey, Egypt, Albania
and Greece were included. Median duration from initial symptoms to the
time of diagnosis was 78 days. The most common complications presented
before diagnosis were abscesses (69%), neurologic deficits (40%),
spinal instability (21%) and spinal deformity (16%). Lumbar (56%),
thoracic (49%) and thoracolumbar (13%) vertebrae were the most
commonly involved sites of infection. Although 51% of the patients had
multiple levels of vertebral involvement, 8% had noncontiguous
involvement of multiple vertebral bodies. The causative agent was
identified in 41% of cases. Histopathologic examination was performed
in 200 patients (64%), and 74% were consistent with tuberculosis.
Medical treatment alone was implemented in 103 patients (33%), while
211 patients (67%) underwent diagnostic and/or therapeutic surgical
intervention. Ten percent of the patients required more than one
surgical intervention. Mortality occurred in 7 patients (2%), and 77
(25%) developed sequelae. The distribution of the posttreatment
sequelae were as follows: 11% kyphosis, 6% Gibbus deformity, 5%
scoliosis, 5% paraparesis, 5% paraplegia and 4% loss of sensation.
Older age, presence of neurologic deficit and spinal deformity were
predictors of unfavourable outcome. ST results in significant morbidity
as a result of its insidious course and delayed diagnosis because of
diagnostic and therapeutic challenges. ST should be considered in the
differential diagnosis of patients with vertebral osteomyelitis,
especially in tuberculosis-endemic regions. Early establishment of
definitive aetiologic diagnosis and appropriate treatment are of
paramount importance to prevent development of sequelae. Clinical
Microbiology and Infection (C) 2015 European Society of Clinical
Microbiology and Infectious Diseases. Published by Elsevier Ltd. All
rights reserved."
}