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KMID : 1146020120050020068
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Journal of Critical Spine Cases
2012 Volume.5 No. 2 p.68 ~ p.72
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Postoperative Spinal Tuberculosis at the Posterior Element of Spinal Column: Case Report
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Shim Hyeong-Ki
Cho Hyung-Lea
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Abstract
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Atypical spinal tuberculosis are rarely reported and are often subject to diagnostic delays and even errors. Post-operative infection with Mycobacterium tuberculosis is extremely rare and has been scarcely reported. We are reporting a case of postoperative spinal tuberculosis of the posterior element of the spinal column. A 60-year-old woman presented with low back pain, a hump on her upper back and gait disturbance lasting for 1 month. Any infection signs such as fever, cough, sputum were not presented. Her lung sound was clear. Motor strength in both extensor hallucis longus muscle was decreased to a grade of 4/5 and sensory function in touch was decreased in the right L5 dermatome. Magnetic resonance imaging with gadolinium contrast revealed that thecal sac was compromised by extradural dorsal mass with rim enhancement. Posterior laminectomy with abscess drainage was performed at the L4-5 level and biopsy specimens were taken. 1×1 sized gray colored granulomas was observed outside the dura mater. The final diagnosis was confirmed by histopathological examination of the extradural mass in the spinal canal along with the result of tuberculosis - polymerase chain reaction in the lesion. Differential diagnosis of the obscure postoperative spinal lesion should include tuberculosis because a complete cure is possible with early treatment and morbidity is high in neglected cases. Awareness and prompt management will facilitate reduction of the ongoing morbidity of this disease due to significant secondary effects on the spinal cord.
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KEYWORD
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Atypical spondylitis, Postoperative infection, Spinal tuberculosis
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