TITLE:
Vertebral Localization of Multifocal Skeletal Tuberculosis: Case Report and Literature Review
AUTHORS:
Fulbert Kouakou, Alban Slim Mbende, André Tokpa, Nicole Adou, Dominique N’Dri Oka
KEYWORDS:
Multifocale, Vertebroplasty, Skeletal Tuberculosis, Diagnosis, Treatment
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.7 No.2,
April
13,
2017
ABSTRACT: Multifocal skeletal
tuberculosis is a rare condition. The diagnosis is difficult and the treatment
is delayed in the vast majority of cases. A 30-year-old immunocompetent jobless
male complained of thoracic and lumbar spine pain for several weeks, associated
with progressive weight loss without fever. Neurological examination was
normal. CT scanning demonstrated hypodense multifocal lesions of the spine and
the hip. Vertebroplasty was performed successfully. But a pathological
examination of the biopsy of spinal lesions was not conclusive. One month later,
the patient developed an acute spinal cord compression syndrome. Emergency
decompression surgery was performed, which demonstrated the purulent epidural
abscess and osteolysis. The pathological examination was in favor of
tuberculosis. Despite surgical stabilization and cementoplasty, anti-TB therapy
and kinesitherapy, the patient was still significantly limited a few months
later with a flaccid paraplegia. TB infection was cleared at the end of the
two-phase regimen. Atypical
tuberculosis ormultifocal TB poses diagnostic problems especially with metastases,
malignant lymphoma, and multiple myeloma. We report this rare case of mutifocal
skeletal tuberculosis to show the place of vertebroplasty in the management of
spinal tuberculosisor if there is indeed a
potential role that vertebroplasty could have played in spreading spinal
lesions. The patient was informed that non identifying information from the
case would be submitted for publication, and he provided consent.