Cases reported "Tuberculosis, Spinal"

Filter by keywords:



Filtering documents. Please wait...

1/34. hypoglossal nerve injury as a complication of anterior surgery to the upper cervical spine.

    Injury to the hypoglossal nerve is a recognised complication after soft tissue surgery in the upper part of the anterior aspect of the neck, e.g. branchial cyst or carotid body tumour excision. However, this complication has been rarely reported following surgery of the upper cervical spine. We report the case of a 35-year-old woman with tuberculosis of C2-3. She underwent corpectomy and fusion from C2 to C5 using iliac crest bone graft, through a left anterior oblique incision. She developed hypoglossal nerve palsy in the immediate postoperative period, with dysphagia and dysarthria. It was thought to be due to traction neurapraxia with possible spontaneous recovery. At 18 months' follow-up, she had a solid fusion and tuberculosis was controlled. The hypoglossal palsy persisted, although with minimal functional disability. The only other reported case of hypoglossal lesion after anterior cervical spine surgery in the literature also failed to recover. It is concluded that hypoglossal nerve palsy following anterior cervical spine surgery is unlikely to recover spontaneously and it should be carefully identified.
- - - - - - - - - -
ranking = 1
keywords = upper
(Clic here for more details about this article)

2/34. Atypical forms of spinal tuberculosis: case report and review of the literature.

    OBJECTIVE: The object of this report is to highlight some of the less known atypical features of spinal tuberculosis (TB) in the hope of facilitating early diagnosis. Pure neural arch and sacral TB is rare and the co-existence of these two as widely separated skip lesions in the same patient is even rarer. CLINICAL PRESENTATION: An unusual case of tuberculous process affecting the sacrum as well as the neural arches of upper cervical vertebrae is presented. Neither the clinical features nor the imaging techniques, including radiography, bone scintigraphy, computed tomography, and magnetic resonance imaging, were helpful in establishing the diagnosis. The destructive lesion of the sacrum with a rectally palpable presacral mass was thought to be a chordoma or chondrosarcoma until the patient developed upper cervical cord compression with an extradural myelographic block. Development of this second destructive lesion involving the posterior spinal elements (the neural arch) led to a diagnosis of malignant spinal metastasis. The true diagnosis was only revealed by the histology of the solid tumor-like extradural mass in the upper cervical region and demonstration of acid-fast bacilli (AFB) in the lesion. Anti-TB chemotherapy resulted in complete resolution of sacral and cervical lesions as well as the neurologic deficits. CONCLUSION: Differential diagnosis of the obscure spinal lesion should include tuberculosis, specifically the atypical forms; especially because complete cure is possible with early treatment and neurologic morbidity is high in neglected cases.
- - - - - - - - - -
ranking = 0.5
keywords = upper
(Clic here for more details about this article)

3/34. mycobacterium xenopi infection of the spine: a case report and literature review.

    STUDY DESIGN: A case report of mycobacterium xenopi. OBJECTIVES: To present a case report of a vertebral osteomyelitis caused by M. xenopi and to review the world literature on the subject. SUMMARY OF BACKGROUND DATA: M. xenopi is most commonly a pulmonary pathogen in immunosuppressed patients or those with underlying lung disease. infection of the spine is very rare, with only four cases reported. Three of these cases occurred in immunosuppressed patients, and the fourth in a patient with previous tuberculosis osteomyelitis of the spine. methods: The information was obtained from a review of the patient's clinical notes and follow-up appointments. RESULTS: The patient was a 73-year-old woman with an M. xenopi osteomyelitis of T6-T7, confirmed by magnetic resonance imaging and a computed tomography-guided biopsy. She was treated with surgical decompression and stabilization before a 2-year antibiotic regimen was begun. At follow-up assessment 1 year after the antibiotics were finished, she still had some ongoing back pain, but no evidence of relapse. CONCLUSIONS: This is the first reported case of an M. xenopi infection of the spine in a patient with no predisposing factors. This type of infection can be difficult to treat, with a high relapse rate reported despite prolonged courses of antibiotics.
- - - - - - - - - -
ranking = 56.62625171843
keywords = back pain, back
(Clic here for more details about this article)

4/34. Infective discitis as an uncommon but important cause of back pain in older people.

    case reports: two elderly patients (aged 70 and 80 years) presented with severe back pain and restriction of spinal movements. Inflammatory markers were raised and in each case computed tomography findings confirmed infective discitis. One patient improved with antibiotics but the second developed paraplegia, a recognized complication of discitis. CONCLUSION: the association of back pain, restricted spinal movements and raised inflammatory markers should act as 'red flags', alerting the clinician to the presence of serious, but potentially treatable pathology.
- - - - - - - - - -
ranking = 339.75751031058
keywords = back pain, back
(Clic here for more details about this article)

5/34. Atlantoaxial tuberculosis: three cases.

    Tuberculosis of the craniocervical junction (CCJ) is exceedingly rare but carries a risk of compression of the medulla oblongata and upper spinal cord. Three cases among 63 patients with spinal tuberculosis are reported. Mean age was 51 years (range, 20-69) and mean time to diagnosis was 4.6 months (range, 1-8). Although atlantoaxial dislocation was a consistent feature, none of the patients had neurological deficits. Computed tomography of the CCJ disclosed a suggestive pattern combining osteolysis and an abscess anterior to the spine. The diagnosis was confirmed by microbiological studies in two cases and histology in one. The outcome was favorable after antituberculous therapy, immobilization of the neck, and surgical fusion. Although tuberculosis remains common in developing countries, involvement of the CCJ is rare. Tuberculosis of the CCJ carries a risk of instability and severe neuraxis compression. Consequently, early diagnosis and treatment are of the utmost importance.
- - - - - - - - - -
ranking = 0.16666666666667
keywords = upper
(Clic here for more details about this article)

6/34. Cervico thoracic junction spinal tuberculosis presenting as radiculopathy.

    A case of cervico thoracic junctional area spinal tuberculosis presenting as painful radiculitis of the upper extremity is reported. The predominant symptom of radicular pain and muscle weakness in the hand, along with a claw deformity, led to considerable delay in diagnosis. The presence of advanced bone destruction with severe instability was demonstrated on the MRI scan done later. Surgical management by radical anterior debridement and fusion, along with chemotherapy, led to resolution of the upper extremity symptoms. The brachial plexus radiculopathy secondary to tuberculosis has not been reported. The absence of myelopathic signs even in the presence of advanced bone destruction, thecal compression and instability is uncommon in adults.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = upper
(Clic here for more details about this article)

7/34. Tuberculosis of the spine (Pott's disease) presenting as 'compression fractures'.

    STUDY DESIGN: case reports and survey of literature. OBJECTIVE: case reports of two women with tuberculosis (TB) of the spine (Pott's disease) presenting with severe back pain and diagnosed as compression fracture are described. physicians should include Pott's disease in the differential diagnosis when patients present with severe back pain and evidence of vertebral collapse. SETTING: ohio, USA methods: A review of the literature on the pathogenesis, pathophysiology, clinical presentation, diagnostic methods, treatment and prognosis of spinal TB was conducted. RESULTS: After initial delay, proper diagnosis of spinal TB was made in our patients. Microbiologic diagnosis confirmed M. tuberculosis, and appropriate medical treatment was initiated. CONCLUSIONS: Although uncommon, spinal TB still occurs in patients from developed countries, such as the US and europe. back pain is an important symptom. Vertebral collapse from TB may be misinterpreted as 'compression fractures' especially in elderly women. magnetic resonance imaging scan (MRI) is an excellent procedure for the diagnosis of TB spine. However, microbiologic diagnosis is essential. mycobacterium tuberculosis may be cultured from other sites. Otherwise, biopsy of the spine lesion should be done for pathologic diagnosis, culture and stain for M. tuberculosis. Clinicians should consider Pott's disease in the differential diagnosis of patients with back pain and destructive vertebral lesions. Proper diagnosis and anti-tuberculosis treatment with or without surgery will result in cure.
- - - - - - - - - -
ranking = 169.87875515529
keywords = back pain, back
(Clic here for more details about this article)

8/34. psoas abscess: the spine as a primary source of infection.

    STUDY DESIGN: Case report, literature review, discussion. OBJECTIVES: To emphasize the role of the spine as primary source of infection for psoas abscess. SUMMARY OF BACKGROUND DATA: spine-associated psoas abscesses increase with more frequent invasive procedures of the spine and recurring tuberculosis in industrialized countries. Diagnosis is often delayed by misinterpretation as arthritis, joint infection, or urologic or abdominal disorders. methods: We present six cases of psoas abscesses associated with spinal infections that were treated in our hospital from January to December 2001. Diagnostic and treatment concepts are discussed. RESULTS: Our data emphasize the importance of the spine as primary source of infection and suggest an increase in the incidence of secondary psoas abscess. Treatment includes open surgical drainage and antibiotic therapy. In patients with high operative risk and uniloculated abscess, a CT-guided percutaneous abscess drainage can be sufficient. It is essential to combine abscess drainage with causative treatment of the primary infectious focus. Related to the spine, this includes treatment of spondylodiscitis or implant infection after spinal surgery. Usually, several operations are necessary to eradicate bone and soft-tissue infection and restore spinal stability. Continuous antibiotic therapy over a period of 2-3 weeks after normalization of infectious parameters is recommended. CONCLUSION: The spine as primary source of infection for secondary psoas abscess should always be included in differential diagnosis. Because the prognosis of psoas abscess can be improved by early diagnosis and prompt onset of therapy, it needs to be considered in patients with infection and back or hip pain or history of spinal surgery.
- - - - - - - - - -
ranking = 3.7596904020425
keywords = back
(Clic here for more details about this article)

9/34. Concomitant spine infection with mycobacterium tuberculosis and pyogenic bacteria: case report.

    STUDY DESIGN: A case report of an extremely rare condition describing lumbar spine tuberculosis associated with concurrent pyogenic infection is presented. OBJECTIVE: To establish that isolation of pyogenic bacteria from an infected spine does not exclude the possibility of spine tuberculosis. SUMMARY OF BACKGROUND DATA: During a medline data search from January 1960 through October 2001, no cases of combined spine tuberculosis and pyogenic infection were found. methods: A 52-year-old man reported left-side gluteal swelling, backache, and fever of 20 days duration. A similar swelling in the same location had occurred 12 years previously, and an operation was performed at that time. Preoperative syringe-aspirated material from a gluteal abscess was sent for ordinary bacteriologic culture (for only aerobic pyogenic bacteria). During the operation, a needle-aspirated specimen of evacuated pus was subjected to direct microscopy and culture. Direct Gram stain for pyogenic bacteria and direct Ziehl-Neelsen stain for mycobacteria were performed. Cultures for aerobes, anaerobes, mycobacteria, and fungi were made. RESULTS: The preoperative specimen culture showed growth of nocardia asteroids and moraxella catarrhalis, whereas the operative specimen showed gram-positive cocci and acid-fast bacilli on direct smears. The operative cultures yielded growth of nocardia asteroids, moraxella catarrhalis, and mycobacterium tuberculosis. Plain lumbar spine radiograph showed psoas muscle calcification. CONCLUSIONS: It is concluded from this case that recovery of pyogenic bacteria from an infected spine does not exclude spine tuberculosis. It is recommended, therefore, that mycobacterial investigations be performed for cases that have evidence of tuberculosis, even when pyogenic microorganisms already have been isolated. The clues that raise suspicion of tuberculosis in patients with pyogenic spine infection include chronic infection that does not respond to ordinary antibiotics, isolated pyogenic bacteria of low virulence, psoas muscle calcification, and immunosuppression.
- - - - - - - - - -
ranking = 3.7596904020425
keywords = back
(Clic here for more details about this article)

10/34. An unusual case of CV junction tuberculosis presenting with quadriplegia.

    STUDY DESIGN: Isolated tubercular involvement of craniovertebral junction in a human immunodeficiency virus-positive patient causing paraplegia and sudden death with radiologic features is presented. OBJECTIVES: Isolated involvement of craniovertebral junction by tuberculosis causing quadriparesis is a rare entity. The role of imaging features is presented in diagnosis of craniovertebral junction tuberculosis, which is a treatable disease. Early detection of this entity with prompt treatment can prevent a fatal outcome. SUMMARY OF BACKGROUND DATA: Tuberculosis of the cervical spine is a rare and potentially dangerous manifestation of extrapulmonary tuberculosis. The incidence is probably less than 1% of all cases of spinal tuberculosis. However, in the developing countries this constitutes an increasingly important cause of craniovertebral junction instability and cervicomedullary compression. Most of the patients present with pain in the neck and local tenderness. Neurologic deficits of varying degrees have been reported in 24-40% of cases of craniovertebral junction tuberculosis. quadriplegia followed by sudden death is exceptional (as seen in our case). The incidence of craniovertebral junction tuberculosis in immunocompromised patients is not known. Dramatic recovery is possible if craniovertebral junction tuberculosis is detected early in its course. Prompt medical and surgical treatment may avert a potential catastrophic event in such cases. Imaging methods such as computed tomography and magnetic resonance imaging are diagnostic of this condition and aid in the detection and prompt treatment of the same. METHOD: Frontal radiograph of the cervical spine and chest, and lateral view of cervical spine followed by plain and contrast enhanced computed tomography scan of the cervical spine was performed to detect the lesion. RESULT: These radiographic features were correlated with the clinical findings. The computed tomography findings of bone destruction, prevertebral and extradural peripherally enhancing soft tissue and infiltrating opacities in the lung apexes were consistent with tuberculosis. CONCLUSIONS: The computed tomography findings described in this report are very specific for tuberculosis of the craniovertebral junction. Clinical and radiologic correlation could help in making the early diagnosis and prompt treatment possible.
- - - - - - - - - -
ranking = 0.1341755744466
keywords = chest
(Clic here for more details about this article)
| Next ->


Leave a message about 'Tuberculosis, Spinal'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.