Atypical Tuberculous Spondylitis: A Report of Two Cases

ABSTRACT

STUDY DESIGN: Case study of two cases. OBJECTIVES: The aim of our study is to describe atypical patterns of tuberculous spondylitis. SUMMARY OF LITERATURE REVIEW: Few reports of tuberculous spondylitis have discussed atypical cases, which resulted in a poor prognosis due to the delay in early diagnosis and proper treatment. MATERIALS AND METHODS: A 74-year-old female underwent an incision and drainage, and posterior decompression and fusion (PDF) due to tuberculous epidural abscess after vertebroplasty of a compression fracture at T12. A 52-year-old female underwent interbody fusion and posterior lateral fusion (PLF) because of aggravation of an abscess and neurologic symptoms following non-invasive intervention to treat atypical tuberculous spondylitis. RESULTS: Clinical symptoms and serological tests of the patients were improved at postoperative 6 months. CONCLUSIONS: When a patient presents with focal bony or soft tissue abnormality on an image study, the possibility of non-typical tuberculous spondylitis has to be considered when infective spondylitis or a tumor is detected. Moreover, an invasive diagnosis tool such as biopsy will be needed for proper management.