Presentation
Leg weakness.
Patient Data
Destruction of T12 and L1, with a resultant gibbus. The destructive process is centered on the T12/L1 disc space.
Images courtesy of Dr. Selvam (Neurosurgeon, RIPAS Hospital, Brunei).
T12/L1 spondylodiscitis - with avid contrast enhancement involving the T11-L2 vertebral bodies, T12/L1 disc space, and the adjacent paravertebral collections.
A plethora of collections as a consequence of spondylodiscitis are evident - the so-called 'cold abscesses' of TB, with intense ring enhancement.
Case Discussion
This case demonstrates a rather extreme example of tuberculous spondylodiscitis.
A gibbus deformity has occurred secondary to a severe T12/L1 spondylodiscitis, with impingement of the spinal cord, just proximal to the conus.
The following collections are present :
bilateral psoas
anterior and posterior vertebral (subligamentous)
deep subcutaneous
erector spinae and quadratus lumborum