Tuberculosis of the Spine: A new Understanding of an Old Disease

Kee-Yong Ha; Ki-Tae Na; Se-Rine Kee; Young-Hoon Kim

doi:10.4184/jkss.2014.21.1.41

Journal List > J Korean Soc Spine Surg > v.21(1) > 1076042

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Ha, Na, Kee, and Kim: Tuberculosis of the Spine: A new Understanding of an Old Disease

Original Article

Journal of Korean Spine Surg 2014;21(1):41-47.

Published online: 21 March 2014

DOI: https://doi.org/10.4184/jkss.2014.21.1.41

Tuberculosis of the Spine: A new Understanding of an Old Disease

Kee-Yong Ha, M.D., Ki-Tae Na, M.D., Se-Rine Kee, M.D., Young-Hoon Kim, M.D.

Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Corresponding author: Young-Hoon Kim, M.D., Ph.D. Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea. 222 Banpo-daero, Seocho-gu, Seoul, Korea. TEL 82-2-2258-6118, FAX: 82-2-535-9834 E-mail: boscoa@catholic.ac.kr

Received 15 May 2012 Revised 4 July 2012 Accepted 22 November 2012

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

Study Design

A review of related literatures of diagnosis and treatment of spinal tuberculosis.

Objectives

The aim of the study was to discuss treatment strategies by understanding of emerging problems related to spinal tuberculosis.

Summary of Literature Review

Owing to modern diagnostic modalities, development of prevention and chemotherapy, the incidences of tuberculosis infection including spinal tuberculosishave been decreasing. Moreover, these medical these improvements of medical and surgical treatments the improvement of surgical techniques for spinal tuberculosis reduced the incidence of kyphosis or neurologic complications such as Pott's paralysis.

Materials and Methods

Review of related literatures.

Results

Recently, the occurrence of multi-drug resistant strain, an increasing number of opportunistic infections and an atypical presentation in spinal tuberculosis are emerging as new challenges.

Conclusions

An appropriate diagnosis and surgical interventions are our obligation as clinicians dealing with this unique infectious disease to minimize the complications for the treatment of spinal tuberculosis.

Keywords: Spine, Spinal tuberculosis, Kyphosis, Atypical spinal tuberculosis, Multi-drug resistant

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Fig. 1.

A 29-year-old male with back pain. A typical tuberculous spondylitis T2-weighted-fat-suppression MR image shows high signal intensity at the 11 ^th and 12 ^th thoracic spine and the 2 ^nd and 3 ^rd lumbar spine. And there are epidural abscess at the thoracic spine and sub-ligamentous abscess extension at the lumbar spine.

Fig. 2.

A 44-year-old male with old tuberculous spondylitis history. Severe kyphosis was noted at the upper thoracic spine.

Fig. 3.

A 60-year-old female (A) Tuberculous spondylitis was occurred at the 7 ^th and 8 ^th thoracic spine, and there was associated compression fracture at the 8 ^th thoracic spine. (B) After 8-month of chemotherapy, suc-cessful recovery was achieved with mild kyphosis sequel.

Fig. 4.

A 25-year-old male with tuberculous spondylitis at the 3 ^rd and 4 ^th lumbar spine. (A) A preoperative T1 weighted sagittal MR image shows destructive lesion involving the lumbar spine with paraspinal abscess. (B) Preoperative lateral X-ray shows destructive bony lesion with kyphosis.(C) Postoperative lateral X-ray showing anterior and posterior fusion (Hong-Kong method) status. (D) After 3-year followup, eradication of tuberculosis and bony union were achieved.

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