J Korean Soc Spine Surg.  2012 Mar;19(1):25-30. 10.4184/jkss.2012.19.1.25.

Tuberculosis Spondylitis T4-6 with Compression Fracture T5: A Case Report

• Shim HY
• Lee HL
• Park KD
• Lee JK
• Lim OK

• KMID: 2097862
• DOI: http://doi.org/10.4184/jkss.2012.19.1.25

Abstract

STUDY DESIGN: Case report
OBJECTIVES
We report a case of a female patient who had only upper back pain without neurological symptoms and was later diagnosed with spine tuberculosis in combination with a compression fracture. SUMMARY OF LITERATURE REVIEW: Spine tuberculosis is the most common type of musculoskeletal tuberculosis. However, the indolent nature of tuberculous bone and joint disease often leads to delayed diagnosis and severe neurologic complications. MATERIAL AND METHODS: A 37-year-old female with only upper back pain for five months was admitted. She had no signs, symptoms or past histories related to tuberculosis. She had taken conservative management, but symptoms persisted.
RESULTS
By doing motor and sensory evoked potential studies, we questioned spinal cord jury. Then, we confirmed spine tuberculosis T5 with T4 compression fracture by thoracic magnetic resonance imaging and pathologic findings.
CONCLUSIONS
When a patient presents constant back pain without neurological symptoms, image study and electromyography should be evaluated.

Keyword

Spinal tuberculosis; Compression fracture; Back pain

MeSH Terms

Adult
Back Pain
Delayed Diagnosis
Electromyography
Evoked Potentials
Female
Fractures, Compression
Humans
Joint Diseases
Magnetic Resonance Imaging
Spinal Cord
Spine
Spondylitis
Tuberculosis
Tuberculosis, Spinal

Figure

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  Fig. 1. Preoperative posteroanterior view of the chest radiography shows no active lesion in both lungs.

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  Fig. 2. Preoperative posteroanterior and lateral view of the cervical X ray shows no remarkable finding.

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  Fig. 3. Magnetic resonance Sagittal T2-weighted images shows high signal in T4-6, which is abscess formation and inflammation involvement of Rt. posterior epidural space and posterior elements and compression fracture T5.

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  Fig. 4. Sensory evoked potentials. (A) Right median nerve SEP (B) Left median nerve SEP (C) Right tibial nerve SEP (D) Left tibial nerve SEP

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