Role of vitamin D in patients with Potts spine

Abstract

Potts spine is caused by Mycobacterium tuberculosis, a slow growing gram-positive, acid-fast bacillus which becomes lodged in the bone via Batson’s venous plexus and lymphatic from primarily infected lung, lymph nodes, mediastinum and viscera, forming granulomatous inflammation and caseation necrosis. Pott's spine accounts for 2% of all cases of TB, 15% of extrapulmonary, and 50% of skeletal TB. The paradiscal, central, anterior subligamentous, and neural arch are the common vertebral lesions. Thoracic vertebrae are commonly affected followed by lumbar and cervical vertebrae. Vitamin D is known to play a role in regulating the immune system, and it has been suggested that a deficiency in vitamin D may contribute to the development of autoimmune disorders such as Potts spine. Studies have shown that individuals with Potts spine have lower levels of vitamin D compared to healthy controls. Additionally, vitamin D deficiency has been linked to an increased risk of spinal bone loss and an increased risk of spinal fractures in individuals with Potts spine.Present study was prospective in nature conducted among 4f patients of Potts spine. All patients fulfilling inclusion criteria and exclusion criteria were taken up for the study. Study was carried out over a period of 2 years. Serum vitamin D was assessed. Majority of the patients was in the age group of 41-50 years and most of them were male. In this study, serum vitamin D level was optimal (>30 ng/ml) in 16 (36.36%) cases, deficient (<20 ng/ml) in 16 (36.36%) cases and insufficient (20-30 ng/ml) among 12 (27.28%) cases. Reduced serum levels of vitamin D are associated with increased spinal cord compression & disease severity as suggested by the bowel bladder involvement & sensory involvement at levels <20 ng/ml, level 1 spinal cord compression at optimal (>30 ng/ml) vitamin D level, level 2 spinal cord compression at 20-30 ng/ml (insufficient) and level 3 spinal cord compression at deficient (<20 ng/ml) vitamin D level. So, there is an inverse relationship between the level of vitamin D & severity of disease in Pott’s spine.