Mal de Pott en la Provincia del Chaco.

IntroductionTuberculosis (TB) is the seventh leading cause of death. Spinal involvement represents less than 1 % of cases.ObjectiveTo investigate our state frequency of Pott disease, to typify its profile and to identify guidelines for similar regions.MethodsVerify all TB admissions during 1996 – 2014 period (19 years) in main state hospitals.  Medical records review of all cases with spinal involvement. Frankel and GATA classifications. Data from last national census. Literature review.Results14 cases: 8 males/6 females. Average age: 35.4 years (3.8 - 63). Follow-up: 2.8 years (1 month – 15 years); an immediate postoperative death. Seven patients came from low TB burden departments. Initial symptoms: neurological impairment 9, pure axial and/or radicular pain 4 and pure spine deformity 1 patient.  Initial Frankel: E 5 cases, D2, C 2 and A 5 patients. Localization: Thoracic, 5; Thoraco-lumbar, 6; Lumbar, 1; Multiple 2 patients.Ethnic distribution: 5 Caucasian, 5 natives, 3 creoles, 1 mestizo. According to GATA classification: 1 Type IB lesion; 4 Type II; 8 Type III; 1 unclassifiable case. Native patients had more severe neurological hospital admission profile and GATA lesions.Twelve patients were operated on with 10 instrumentations. At follow-up: 8 asymptomatic cases, 4 deceased and 2 cases with moderate symptoms. Five cases improved neurological status; no worsening was found. Of 11 survivors operated cases 5 had residual spine deformity. No difference existed among double instrumentation, isolated posterior one or no instrumentation.IntroducciónLa tuberculosis (TB) es la séptima causa de muerte mundial. Compromete al raquis en menos del 1 % de los casos.ObjetivoInvestigar la frecuencia provincial del Mal de Pott, caracterizar su perfil e identificar pautas para regiones similares.Material y MétodosRastreo de internados por TB del período 1996 – 2014 (19 años) en Hospitales provinciales de cabecera.  Revisión de Historias de casos raquídeos. Clasificaciones de Frankel y de GATA. Datos de últimos censos nacionales. Revisión bibliográfica.Resultados14 casos: 8 varones/6 mujeres. Edad promedio: 35.4 años (3.8 - 63). Seguimiento: 2.8 años (1 mes – 15 años); un óbito postoperatorio inmediato. Siete pacientes provenían de departamentos con baja carga de morbilidad de TB. Síntomas de presentación: déficit neurológico 9, dolor axial y/o radicular puros 4 y deformidad vertebral pura 1 paciente.  Frankel ingreso: E 5 casos, D2, C 2 y A 5 pacientes. Localizaciones: Torácica, 5; Tóraco-lumbar, 6; Lumbar, 1; Múltiple 2 pacientes.Distribución étnica: 5 caucásicos, 5 aborígenes, 3 criollos, 1 mestizo. Según la Clasificación GATA: 1 lesión Tipo IB; 4 Tipo II; 8 Tipo III; 1 caso Inclasificable. Los pacientes de etnia originaria tuvieron cuadros neurológicos y lesiones GATA más severas.Doce pacientes fueron operados. Hubo 10 instrumentaciones. Al seguimiento: 8 asintomáticos, 4 fallecidos y 2 pacientes con síntomas moderados. Cinco mejoraron su estado neurológico; no hubo deterioros. De 11 operados sobrevivientes 5 presentaban deformidad secuelar. No hubo diferencia entre doble instrumentación, instrumentación posterior aislada o sin instrumentación. ConclusionesLas etnias originarias muestran mayor frecuencia, formas más severas, presentaciones avanzadas y de tratamiento quirúrgico habitual. La mortalidad es alta.

Pott's disease in the Chaco Province

Introduction Tuberculosis (TB) is the seventh leading cause of death. Spinal involvement represents less than 1 % of cases. Objective To investigate our state frequency of Pott disease, to typify its profile and to identify guidelines for similar regions. Methods Verify all TB admissions during 1996 – 2014 period (19 years) in main state hospitals.  Medical records review of all cases with spinal involvement. Frankel and GATA classifications. Data from last national census. Literature review. Results 14 cases: 8 males/6 females. Average age: 35.4 years (3.8 - 63). Follow-up: 2.8 years (1 month – 15 years); an immediate postoperative death. Seven patients came from low TB burden departments. Initial symptoms: neurological impairment 9, pure axial and/or radicular pain 4 and pure spine deformity 1 patient.  Initial Frankel: E 5 cases, D2, C 2 and A 5 patients. Localization: Thoracic, 5; Thoraco-lumbar, 6; Lumbar, 1; Multiple 2 patients. Ethnic distribution: 5 Caucasian, 5 natives, 3 creoles, 1 mestizo. According to GATA classification: 1 Type IB lesion; 4 Type II; 8 Type III; 1 unclassifiable case. Native patients had more severe neurological hospital admission profile and GATA lesions. Twelve patients were operated on with 10 instrumentations. At follow-up: 8 asymptomatic cases, 4 deceased and 2 cases with moderate symptoms. Five cases improved neurological status; no worsening was found. Of 11 survivors operated cases 5 had residual spine deformity. No difference existed among double instrumentation, isolated posterior one or no instrumentation