Tuberculous spondylitis (Pott disease) most commonly affects the lower thoracic and upper lumbar region; Tuberculous spondylitis is less commonly involve the cervical and upper thoracic region. Progression of tuberculous spondylitis generally begins with inflammation of the anterior aspect of intervertebral joints; typically, it spreads behind the anterior ligament to involve the adjacent vertebral body. Once two adjacent vertebrae are involved, infection enters the adjoining intervertebral disc space. This tends to occur later in Pott disease than in bacterial vertebral osteomyelitis and may have the radiographic appearance of relative disc sparing. Eventually, the avascular disc tissue dies; there is vertebral narrowing and subsequent vertebral collapse. Gibbus deformity, a form of structural kyphosis, distorts spinal canal anatomy.
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