Multidrug-resistant Tuberculosis Spondylitis

Sung Chan Ki; Ki Soo Kim; Yoon Hong Kim; Yong Soo Choi

doi:10.4184/jkss.2008.15.2.102

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Ki, Kim, Kim, and Choi: Multidrug-resistant Tuberculosis Spondylitis

A Case Report

Journal of Korean Spine Surg 2008;15(2):102-105.

Published online: 12 February 2008

DOI: https://doi.org/10.4184/jkss.2008.15.2.102

Multidrug-resistant Tuberculosis Spondylitis

Sung Chan Ki, M.D., Ki Soo Kim, M.D., Yoon Hong Kim, M.D., Yong Soo Choi, M.D.

Department of Orthopedic Surgery, Kwangju Christian Hospital, Gwang-Ju, South Korea

Address reprint requests to Yong Soo Choi, M.D. Department of Orthopaedic Surgery, Kwangju Christian Hospital 264 Yang-lim dong, Nam-gu, Gwangju, 503-715, Korea Tel: 82-62-650-5060, Fax: 82-62-650-5066, E-mail: stemcellchoi@yahoo.co.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

– Abstract – Multidrug-resistant tuberculosis, resistant to at least isoniazid and rifampicin, continues to present a serious challenge to human health. However, there are no reports addressing multidrug-resistant tuberculous spondylitis in Korea. We report a case of multidrug-resistant tuberculous spondylitis at L2-L3 in a 30-year-old woman.

Keywords: Tuberculosis spondylitis, Multidrug resistance

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Fig. 1.

Preoperative radiographs and MR Imaging. (A) Radiographs show destruction of vertebral body and kyphotic deformity (Sagittal index: 40 degrees) at L2-3. (B) Sagittal T1 and T2-weighted imaging of L2-3 demonstrate destruction of vertebral bodies and compression of dural sacs. Axial T2-weighted images show the abscess formation at psoas muscle, right.

Fig. 2.

Histologic finding shows caseous necrosis with chronic granulated inflammation (H-E×100).

Fig. 3.

Radiographs and MR Imaging at 26months after the operation. (A) Radiographs show collapse of grafted bone, destruction of vertebral bodies and kyphotic deformity at L2-4. (B) Sagittal T1 and T2-weighted imaging of L2-4 demonstrate destruction of vertebral bodies and severe compression of dural sacs. Axial T2-weighted images show the large abscess formation at psoas muscle and fistula formation, right.

Fig. 4.

Tuberculosis drug sensitivity test result in drug-resistant for Isoniazid, Rifampicin and Streptomycin.

Fig. 5.

Radiographs at 18months after 2nd operation show well bony fusion at L2-3-4.

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