Atypical forms of spinal tuberculosis

Abstract

Twenty-three patients with atypical forms of spinal tuberculosis treated between 1975 and 1985, are described. All presented with signs and symptoms of compression of the spinal cord or cauda equina, ranging from paraesthesiae and increasing weakness of extremities to paraplegia and loss of sphincter control. None of them showed visible or palpable spinal deformity nor the typical radiographic appearance of destruction of the intervertebral disc and the two adjoining vertebral bodies. These atypical forms constituted about 12 percent of all the cases of spinal tuberculosis seen (a total of 190 cases); and fell into three well-defined groups: those with the involvement of neural arch only; those with the involvement of a single vertebral body; and, those without bony involvement. The correct surgical approach in these groups was found to be different: spinal cord compression caused by the tuberculous disease of the neural arch was best treated by laminectomy; whereas single vertebral body disease required an anterior or anterolateral approach. Spinal computerized tomography was helpful in defining the extent of disease and planning the surgical approach. Histological confirmation of tuberculosis was obtained in all the cases and acid fast bacilli (A.F.B.) were found in, and cultured from, the biopsy specimens of 18 cases.

Isolated tuberculous arthritis of the dorsal facet joint

“…[12]. Dissemination is often done by hematogenous way and the damage of the posterior arch of the vertebra during tuberculosis is rather secondary to venous spread (via the posterolateral venous plexus) [13]. Complications reported in the literature can be either local such as epiduritis or paraspinal abscess as in our patient, or remotely such as meningitis, endocarditis or osteo-articular infection [5,10].…”

Unknown Case

“…It was originally described by Naim-ur-Rahman who also warned that it is most likely to be mistaken for a metastatic lesion. 2 The authors highlight the following atypical features in this patient.…”

An Unusual Case of CV Junction Tuberculosis Presenting with Quadriplegia

“…The atlantoaxial junction is the least common site for the presentation of spinal tuberculosis, accounting for just 1% of all cases of spinal tuberculosis. 1,2,9 The lateral masses of the atlas are involved in 72%, dens in 62%, and those are the most common sites of involvement of C1 and C2. Paraspinal abscesses in tuberculous spondylitis are found in 55-96% of cases.…”