Tuberculous spondylitis

Case contributed by Dr Hidayatullah Hamidi

Presentation

Back pain, fever and bilateral lower limb pain for 4 months.

Patient Data

Age: 30 years
Gender: Male
MRI

Almost complete infiltrative destruction of the T12 vertebra with partial destruction and inflammatory changes of anterior aspects of the T9, T10, T11 and L1 vertebrae. There is an associated acute kyphotic deformity, centered at T12. 

Large prevertebral, intravertebral, paraspinal and epidural abscess extending from the T9 vertebral level to the L1 level into the proximal parts of left psoas muscle.

The epidural collection results in significant spinal canal stenosis and cord compression.

Case Discussion

Tuberculous spondylitis is the involvement of vertebral body and discs with tuberculosis infection. Slow collapse of one or more vertebral bodies results in kyphotic deformity.  In late stages of disease, large paraspinal abscesses are common.

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