Poster 299 Moyamoya Disease: A Case Report

Abstract

tion, groin paresthesias, or falls. Magnetic resonance imaging revealed wedge collapse of the T5 and T6 vertebral bodies with intervertebral disk destruction and epidural abscess. Urgent thoracic decompression with debulking and posterior fusion was performed. Biopsy revealed Mycobacterium tuberculosis. He received appropriate antibiotics for 1 year. At 1-year follow-up, he regained full strength throughout the lower extremities without evidence of myelopathy. He did, however, have focal tenderness of the left rhomboid major and latissimus dorsi. Setting: Outpatient spine clinic. Results: Repeated spinal films were obtained and showed no hardware failure. The patient was referred to physical therapy for stretching and strengthening of the latissimus dorsi and rhomboids, posture education, and a home exercise program. Discussion: Roughly a third of the global population is infected with Mycobacterium tuberculosis. India had the highest incidence of the disease with 2 million cases reported by the World Health Organization in 2009. Unfortunately, early symptoms of Pott disease are often mistaken for axial low back pain, and the diagnosis is often delayed. Nonetheless, rehabilitation of patients with Pott disease requires a multidisciplinary approach to maximize motor and functional outcomes. Conclusions: A high clinical suspicion of spinal tuberculosis should be considered in foreign-born patients from endemic regions who present with mid or low back pain despite absence of constitutional symptoms or neurologic compromise. Early diagnosis and appropriate medical and/or surgical care should be combined with an early rehabilitation program to improve quality of life after spinal tuberculosis.