Surgical management of Pott’s disease in Madagascar: A retrospective analysis of 36 cases in a neurosurgical setting

Background: Pott’s disease, or tuberculous spondylodiscitis, is a severe form of osteoarticular tuberculosis, posing significant public health challenges due to delayed diagnosis and complex management. Objective: This study aims to describe the surgical management of Pott’s disease and evaluate the clinical and functional outcomes of patients undergoing surgical intervention. Methods: A retrospective study was conducted on 36 patients hospitalized with Pott’s disease between January 2019 and December 2022. Assessment criteria included demographic characteristics, surgical indications, operative techniques, neurological outcomes, and postoperative complications. Results: Surgical intervention was performed in 75% of patients, with complete neurological recovery in 10% and partial functional improvement in 57% of cases. Bone consolidation was achieved in 61.1% of cases at 12 months. Postoperative complications included urinary tract infections and pressure ulcers (18.5%), as well as persistent spinal deformity in 7.4% of cases. One case of septic shock-related mortality was reported. Conclusion: Surgery is an effective therapeutic option for complicated cases of Pott’s disease, particularly in the presence of neurological compression or spinal instability. A multidisciplinary approach integrating antibiotic therapy, surgery, and rehabilitation optimizes functional and neurological outcomes.