Two cases of tuberculous spondylodiscitis: a rare manifestation of extrapulmonary tuberculosis.

Abstract

Osteoarticular manifestations of tuberculosis are the third manner of presentation of extrapulmonary tuberculosis with a frequency less than 5%, being the main site affected the axial skeleton. This is known as tuberculous spondylodiscitis or Pott’s disease, preferably appearing in the dorsal region (1,2). Pott’s disease was first described in 1799 by Percivall Pott as “That kind of palsy of lower limbs witch is frequently found to accompany a curvature of the spine”; but it is known to be one of the oldest diseases to mankind dating back to Egyptian mummies in 3400 BC. It is the most common granulomatous disease of the spine, which is characterized by being chronic and slowly progressive, to its confirmation Mycobacterium tuberculosis isolation or identification of granulomas in a sample obtained from the injured vertebrae is needed (2,3). Imaging studies are important for diseases detection, mainly the computed axial tomography (CT) and magnetic resonance imaging (MRI) which since 1987 have made it possible to detect the disease at a predestructive phase and at rare sites of presentation (1,2). Treatment involves the use of antituberculosis drugs for at least 6 months, and surgery was reserved for cases with progressive deformity or neurological deficit in which medical treatment is not effective, which represents one-third of patients (1,3,4). In the search made in PubMed database there were scarce cases with the same characteristics (5,6). In this report we represent two cases of tuberculous spondylodiscitis.