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Eur Spine J (2013) 22 (Suppl 3):S302S305 DOI 10.1007/s00586-012-2294-z
CHINESE SECTION
Isolated atypical spinal tuberculosis mistaken for neoplasia: case report and literature review
Yang Yu Xinwei Wang Bin Du Wen Yuan
Bin Ni Deyu Chen
Received: 25 August 2011 / Revised: 18 February 2012 / Accepted: 29 March 2012 / Published online: 25 April 2012 Springer-Verlag 2012
AbstractIntroduction We report a case of isolated intra-spinal tuberculosis in a 45 year-old woman. The uncommon ndings in MRI were more suggestive of tumor lesion. Materials and methods After 3 month history of low back pain and 2 weeks radiated pain of right lower extremity, an operation was performed and the total intra-spinal mass was resected. Histological examination revealed a granulomatous necrosis with caseum. Symptoms were greatly improved postoperatively and then the patient was treated with four anti-tuberculosis drugs.
Conclusion This case indicated the complexity of differentiating atypical spinal tuberculosis from disease which could cause spinal cord and cauda equina compression.
Keywords Spinal tuberculosis Spinal tumors
Atypical spondylitis Spinal abscess
Introduction
Tuberculosis (TB) is a common infectious disease worldwide, which usually attacks the lungs. With the discovery of antibiotics, the prevalence of TB has markedly decreased in Europe, but the incidence still remains very high in developing countries. Besides lung, bone joint is the most common site of TB involvement, which accounts for 5 % of all case of TB. Among them, spinal region is easily affected and accounts for almost 50 % of skeletal TB [1]. The classical spinal TB affected anterior aspect of the vertebral body as well as the disc leading to destruction of adjacent vertebral bodies, intervertebral disc and even soft tissues. However, a small number of cases do not have the character of tuberculous spondylitis. These kinds of atypical spinal TB are rarely reported and often make diagnostic delays and even errors [2, 3]. Here we reported an atypical spinal TB mistaken for neoplasia in a female patient.
Case
A 45-year-old female visited the hospital with a history of intermittent back pain for 3 months. Two weeks ago, the soreness worsened with radiating pain to the right lower extremity. She complained of numbness in the right foot especially after movements. There was no history of exposure to TB, no recent weight loss, low-grade...