Tuberculous Epidural Granuloma Simulating a Herniated Lumbar Disk

“…Extension of tuberculous spondylodiscitis to the adjacent ligaments and soft tissue is frequent, varying in the literature from 55% to 96% [9,10,11] . This extension usually occurs antero-laterally; it is rarely observed posteriorly in the peridural space 18 . The paravertebral masses are characterized by thick, irregular enhancement on CT and MR 19 .…”

Section: Tuberculous Spondylodiscitismentioning

confidence: 99%

Imaging of Central Nervous System Tuberculosis

Sensusiati

2017

J Rad Idn

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“…Obwohl wiederholt auf die mögliche und gefährliche Verwechslung von hämatogenen, meist tuberkulösen Spondylitiden mit radikulären Syndromen mit ausschließlich degenerativ bedingten vertebragenen Syndromen hingewiesen worden ist (19,45,51,(58)(59)(60), hat kein einziger Autor bislang die Möglichkeit in Betracht gezogen, daß die postoperative Spondylitis nicht als septische Komplikation zustande gekommen ist, sondern bereits präoperativ vorhanden war, jedoch nicht erkannt worden ist. Daß die Spondylitis in bis zu 90 % der Fälle (18,21,33,42,69) im Anfangsstadium fehldiagnostiziert wird und daß die häufigste Fehldiagnose (30'/o) "Lumbago" oder "Ischias" bei Bandscheibendegeneration lautet, ist ohnehin bekannt (27,52,75).…”

Section: Septic Lesions Of the Intervertebral Disc -Before And After unclassified

Die septischen Bandscheibenschäden - vor und nach Diskotomie

Weber

2008

Z Orthop Ihre Grenzgeb

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Bad results after discotomy for treatment of herniated lumbar disc are caused either by postoperative complications or by preoperative diagnostic errors. Very often other degenerative changes of the "Bewegungssegment" are involved and misunderstood. But also septic lesions of the intervertebral disc following pyogenic hematogenous osteomyelitis of the spine are confused with degenerative lesions. They are even treated operatively as a ruptured intervertebral disc. When pyogenic osteomyelitis may no longer by overlooked after discotomy due to her progression, she is misinterpreted as discitis following removal of intervertebral disc. Only 9 of 97 verified patients with vertebral osteomyelitis suffered from true postoperative infection of the intervertebral space after removal of a herniated disc. In 14 patients the signs of hematogenous osteomyelitis of the spine have been missed or have been explained by degenerative changes of the spine. In none of the patients the wrong diagnosis was perioperatively revised. The common confusion of osteomyelitis and degenerative disc changes can be explained by several reasons: the predilection of lumbar spine and the similarity of local signs of both diseases, the unknown or underestimated frequence of radicular lesions in osteomyelitis of the spine and the difficulties to assess osteomyelitis in early stages by X-ray examination and the frequency of accessory degenerative changes. It may be supposed that many of the reported disc space inflammations after diagnostic or therapeutic means have not been caused by these manipulations but have given occasion for them.(ABSTRACT TRUNCATED AT 250 WORDS)

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Tuberculous Epidural Granuloma Simulating a Herniated Lumbar Disk

Cited by 14 publications

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Imaging of Central Nervous System Tuberculosis

Die septischen Bandscheibenschäden - vor und nach Diskotomie

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