Abstract
Thoracolumbar tuberculosis is a common clinical disease. In this study, a 63 years old female patient had back pain after physical work. X-ray examination showed that the 8th thoracic vertebra was compressed. MR showed that the signal of the 8th thoracic vertebra was abnormal, and T2 showed an obviously high signal. Then, she was misdiagnosed as compression fracture of the thoracic spine at first diagnosis and treated with percutaneous balloon kyphoplasty (PKP) and the pain was gradually aggravated 3 months after the operation; then, lower extremity neurological symptoms began to appear. After that, she was finally diagnosed with tuberculosis of the thoracic spine and received surgery again and then the symptoms were ameliorated significantly, and the muscle strength of both lower limbs recovered. For patients with thoracolumbar compression fractures, we should fully understand the disease history of the disease and perform a detailed examination. The tuberculosis and even tumors should be considered to avoid misdiagnosis.
Highlights
Spinal tuberculosis is the most common secondary tuberculosis outside the lung, accounting for approximately 50% of cases of bone and joint tuberculosis
Spinal tuberculosis is caused by the destruction of spinal bone and intervertebral discs after the body is infected by Mycobacterium tuberculosis, and it can further involve the surrounding accessory and paravertebral muscles, causing tissue degeneration and necrosis
To save nerve function, Mak et al (2013) proposed the following indications for emergency surgery in spinal tuberculosis: 1 progressive deterioration of nerve function; 2 continuous deterioration of spinal deformity; 3 failure of nonsurgical treatment, combined with continuous deterioration of nerve function and spinal deformity or severe pain caused by abscess and spinal instability; 4 diagnosis was difficult to confirm
Summary
Spinal tuberculosis is the most common secondary tuberculosis outside the lung, accounting for approximately 50% of cases of bone and joint tuberculosis. If it is not diagnosed and treated in time, spinal tuberculosis will cause spinal cord and nerve compression as well as paralysis. Spinal tuberculosis often causes abscess formation, spinal cord dysfunction, spinal instability, kyphosis and other complications. Most cases of spinal tuberculosis can be cured with nonsurgical treatment. Surgical treatment is the ultimate treatment approach with the purpose to clear the foci, relieve the compression of the spinal cord and nerves, correct kyphosis and reconstruct the stability of the spine
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