In tuberculous spondylitis the lumbar or lower thoracic spine is most often
involved.
The disease usually begins in the anterior inferior vertebral body*
and spreads beneath the
anterior (or posterior) longitudinal ligament to
involve adjacent vertebral bodies, and secondarily the intervening disc(s).
Osteonecrosis and wedging of vertebral bodies causes a typical
gibbus deformity.
In South Africa, Pott’s disease is the commonest cause of kyphosis in
adults.
Image source (adapted from): http://en.wikipedia.org/wiki/File:Gray301.png
Tuberculous spondylitis
Mr HM, 32 years: In this case the disease is very advanced; complete destruction of a number of vertebrae has resulted in severe kyphosis ("hunchback") as well as scoliosis and loss of height.
A common complication of tuberculous spondylitis is paravertebral,
extradural or other soft tissue cold abscess.
This can in turn result in a draining sinus in the lumbar triangle, groin
or buttocks. In spinal tuberculosis there is seldom direct involvement of
the cord but compression can cause neurologic deficit,
typically Pott's paraplaegia.
(Tuberculosis of the cervical spine is rapidly progressive, and
particularly dangerous due to pressure effects. Tuberculosis of the
cervical spine is very often associated with retropharyngeal abscess.)