Journal List > J Korean Soc Spine Surg > v.19(1) > 1075980

J Korean Soc Spine Surg. 2012 Mar;19(1):25-30. Korean.
Published online March 31, 2012.
© Copyright 2012 Korean Society of Spine Surgery
Tuberculosis Spondylitis T4-6 with Compression Fracture T5 - A Case Report -
Ho-yong Shim, M.D., Ha-lim Lee, M.D., Ki-deok Park, M.D., Ju-kang Lee, M.D., Ph. D. and Oh-kyung Lim, M.D., Ph. D.
Department of Rehabilitation, Gachon University of Medicine and Science, Korea.

Corresponding author: Oh-kyung Lim M.D. Department of Rehabilitation, Gachon University of Medicine and Science 1198, Guwol-dong, Namdong-gu, Incheon, Korea. TEL: 82-32-460-3722, FAX: 82-32-460-3722, Email:
Received October 27, 2011; Revised March 19, 2012; Accepted March 19, 2012.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Study Design

Case report


We report a case of a female patient who had only upper back pain without neurological symptoms and was later diagnosed with spine tuberculosis in combination with a compression fracture.

Summary of Literature Review

Spine tuberculosis is the most common type of musculoskeletal tuberculosis. However, the indolent nature of tuberculous bone and joint disease often leads to delayed diagnosis and severe neurologic complications.

Material and Methods

A 37-year-old female with only upper back pain for five months was admitted. She had no signs, symptoms or past histories related to tuberculosis. She had taken conservative management, but symptoms persisted.


By doing motor and sensory evoked potential studies, we questioned spinal cord jury. Then, we confirmed spine tuberculosis T5 with T4 compression fracture by thoracic magnetic resonance imaging and pathologic findings.


When a patient presents constant back pain without neurological symptoms, image study and electromyography should be evaluated.

Keywords: Spinal tuberculosis; Compression fracture; Back pain


Fig. 1
Preoperative posteroanterior view of the chest radiography shows no active lesion in both lungs.
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Fig. 2
Preoperative posteroanterior and lateral view of the cervical X ray shows no remarkable finding.
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Fig. 3
Magnetic resonance Sagittal T2-weighted images shows high signal in T4-6, which is abscess formation and inflammation involvement of Rt. posterior epidural space and posterior elements and compression fracture T5.
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Fig. 4
Sensory evoked potentials. (A) Right median nerve SEP (B) Left median nerve SEP (C) Right tibial nerve SEP (D) Left tibial nerve SEP
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Table 1
Results of sensory evoked potentials (SEPs)
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Table 2
Results of motor evoked potentials (MEPs)
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1. WHO Library Cataloguing-in-Publication Data. World health statistics; 2010.
2. Friedman B. Chemotherapy of tuberculosis of the spine. J Bone Joint Surg Am 1966;48:451–474.
3. Steven K, Denise IC, Joel AD. In: Spinal cord medicine. Philadelphia: Lippincott Williams & Wilkins; 2002. pp. 500-502.
4. Du Plessis J, Andronikou S, Theron S, Wieselthaler N, Hayes M. Unusual forms of spinal tuberculosis. Childs Nerv Syst 2008;24:453–457.
5. Garg RK. Tuberculosis of the central nervous system. Postgrad Med J 1999;75:133–140.
6. Teo EL, Peh WC. Imaging of tuberculosis of the spine. Singapore Med J 2004;45:43–44.
7. Skendros P, Kamaria F, Kontopoulos V, Tsitouridis I, Sidiropoulos L. Intradural, extramedullary tuberculoma of the spinal cord as a complication of tuberculous meningitis. Infection 2003;31:115–117.
8. Cruickshank GS, Johnston RA. Intradural, extramedullary spinal cord compression from tuberculous granuloma. Br J Neurosurg 1996;10:93–95.
9. Chang DJ, Yoon DM, Kang YS, Yoon KB. Chronic Back Pain Proven to Be Spinal Tuberculosis: A report of 2 cases. Korean J Pain 2008;21:74.
10. Ahn JS, Lee JK, Jeon TS, Kwon YS, Kwak SK. Changes of Kyphotic Angle Following Operative Treatment of Tuberculous Spondylitis. J Korean Soc Spine Surg 2001;8:148–155.
11. Crenshaw AH. In: Campbell's Operative Orethopedics. 8th ed. Saint Louis: The CB Mosby company; 1992. pp. 3802-3823.
12. Craig Liebenson.In: Rehabilitation of the spine. 2nd ed. Baltimore: Lippincott Williams & Wilkins; 2007. pp. 586-611.