J Korean Soc Spine Surg.  2014 Mar;21(1):41-47. 10.4184/jkss.2014.21.1.41.

Tuberculosis of the Spine: A new Understanding of an Old Disease

Affiliations
  • 1Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. boscoa@catholic.ac.kr

Abstract

STUDY DESIGN: A review of related literatures of diagnosis and treatment of spinal tuberculosis.
OBJECTIVES
The aim of the study was to discuss treatment strategies by understanding of emerging problems related to spinal tuberculosis. SUMMARY OF LITERATURE REVIEW: Owing to modern diagnostic modalities, development of prevention and chemotherapy, the incidences of tuberculosis infection including spinal tuberculosishave been decreasing. Moreover, these medical these improvements of medical and surgical treatments the improvement of surgical techniques for spinal tuberculosis reduced the incidence of kyphosis or neurologic complications such as Pott's paralysis.
MATERIALS AND METHODS
Review of related literatures.
RESULTS
Recently,the occurrence of multi-drug resistant strain, an increasing number of opportunistic infections and an atypical presentation in spinal tuberculosis are emerging as new challenges.
CONCLUSIONS
An appropriate diagnosis and surgical interventions are our obligation as clinicians dealing with this unique infectious disease to minimize the complications for the treatment of spinal tuberculosis.

Keyword

Spine; Spinal tuberculosis; Kyphosis; Atypical spinal tuberculosis; Multi-drug resistant

MeSH Terms

Communicable Diseases
Diagnosis
Drug Therapy
Incidence
Kyphosis
Opportunistic Infections
Paralysis
Spine*
Tuberculosis*
Tuberculosis, Spinal

Figure

  • Fig. 1. A 29-year-old male with back pain. A typical tuberculous spondylitis T2-weighted-fat-suppression MR image shows high signal intensity at the 11 th and 12 th thoracic spine and the 2 nd and 3 rd lumbar spine. And there are epidural abscess at the thoracic spine and sub-ligamentous abscess extension at the lumbar spine.

  • Fig. 2. A 44-year-old male with old tuberculous spondylitis history. Severe kyphosis was noted at the upper thoracic spine.

  • Fig. 3. A 60-year-old female (A) Tuberculous spondylitis was occurred at the 7 th and 8 th thoracic spine, and there was associated compression fracture at the 8 th thoracic spine. (B) After 8-month of chemotherapy, suc-cessful recovery was achieved with mild kyphosis sequel.

  • Fig. 4. A 25-year-old male with tuberculous spondylitis at the 3 rd and 4 th lumbar spine. (A) A preoperative T1 weighted sagittal MR image shows destructive lesion involving the lumbar spine with paraspinal abscess. (B) Preoperative lateral X-ray shows destructive bony lesion with kyphosis.(C) Postoperative lateral X-ray showing anterior and posterior fusion (Hong-Kong method) status. (D) After 3-year followup, eradication of tuberculosis and bony union were achieved.


Cited by  2 articles

Atypical Tuberculous Spondylitis - A Report of Two Cases -
Hak Jin Min, Hyung Gon Ryu, Seong Kee Shin
J Korean Soc Spine Surg. 2015;22(3):127-132.    doi: 10.4184/jkss.2015.22.3.127.

Thoracic Vertebral Fracture due to Spinal Tuberculosis which was Misdiagnosed as Matastatic Cancer - A Case Report -
Dae Geun Kim, Jae Hwan Cho, Jae Hyoun Kim, Jung-Ki Ha, Dong-Ho Lee, Choon Sung Lee
J Korean Soc Spine Surg. 2015;22(2):55-59.    doi: 10.4184/jkss.2015.22.2.55.


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