Isolated extradural tuberculous granuloma of the cervical spine: a case report

Ding, Qi; Liu, Zhen; Sun, Xu; Ji, Ming-liang; Wang, Bin; Qiu, Yong

doi:10.1007/s00586-011-2095-9

Cited by 5 publications

(2 citation statements)

References 22 publications

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“…[89] Spinal TB involves either thoracic or lumbar regions predominantly and very rarely cervical spine. [10] Constitutional symptoms such as malaise, evening rise in temperature, loss of weight, and appetite are present in approximately 20%–30% of cases of spinal TB. Cervical TB patients present with neck pain, paresthesia and weakness of the upper and lower limbs.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Spinal Epidural Tubercular and Pyogenic Abscess of Cervical Spine without Bony Involvement

Diyora

Patil

Bhende

et al. 2019

Journal of Neurosciences in Rural Practice

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Spinal epidural abscess (SEA) presents with vertebral body involvement. SEA is mostly pyogenic in developed countries, but in developing countries, tuberculosis is more common cause. Young female presented with fever, neck, and right upper limb pain for 1 month followed by acute onset weakness in the right upper limb. Magnetic resonance imaging study of cervical spine showed contrast-enhancing lesion in C2–C3 epidural region. Surgery-aided by initiation of antibacterial and antitubercular treatment based on culture and histopathological study of pus helped us to get good clinical outcome. One should always keep in mind possibility of tubercular abscess while treating cases of spinal epidural lesions, though it is rare in the absence of osseous involvement. Pyogenic and tubercular abscess can present concurrently and sending pus for culture and sensitivity is must as it plays important role in identifying dual organisms.

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Section: Discussionmentioning

confidence: 99%

Concurrent Spinal Epidural Tubercular and Pyogenic Abscess of Cervical Spine without Bony Involvement

Diyora

Patil

Bhende

et al. 2019

Journal of Neurosciences in Rural Practice

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“…19 Experts recommend that patients with cranio-vertebral junction tuberculosis who fail to respond to 4-6 weeks of antituberculosis treatment and skull traction should be offered surgery. 20 Debridement and decompression of the spinal canal along with fixation of the affected spinal segments can effectively remove compressive granulation tissues, decompress the neuronal structures and restore the spinal structure and stability. 3 A randomized study is needed to establish the exact role of surgery in patients with cervical spine tuberculosis (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

Outcome assessment in conservatively managed patients with cervical spine tuberculosis

et al. 2014

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Study design: Cervical spine tuberculosis is a relatively less frequent form of spinal tuberculosis. Cervical spine tuberculosis has a greater propensity to involve the spinal cord and results in major sensory motor deficit. In this prospective study, we aimed to evaluate the clinical and imaging predictors of outcome in conservatively managed patients. Methods: In this study, 42 patients of cervical spine tuberculosis were included. Patients were subjected to a detailed clinical evaluation and magnetic resonance imaging. Patients were treated with antituberculosis treatment and were followed up for 18 months. The Modified Barthel index (MBI) was used to assess the disability. Good outcome was defined as MBI 412 and poor outcome as MBI p12. Clinical and imaging characteristics were used to analyze the predictors of outcome, using univariate and multivariate analysis. Results: Four (9.5%) patients required surgery. Data from 38 patients, who were conservatively managed, were analyzed for predictors of outcome. Among conservatively managed patients, at presentation, 29 patients had an MBI score of p12. At 18 months, the majority of patients (81.6%) had a good outcome. On univariate analysis, a duration of illness 43 months, a major motor deficit, bladder involvement, flexor spasms, significant cord compression and spinal extension of the abscess were significantly associated with a poor outcome. However, on multivariate analysis significant cord compression (P ¼ 0.003) and spinal extension (P ¼ 0.02) showed a significant correlation with a poor outcome. Conclusion: Medical management was effective in cervical spine tuberculosis. Patients with significant cord compression and spinal extension of the abscess showed poorer outcome.

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Non‐osseous intradural tuberculoma of the thoracic spine with compressive myelopathy

Duvuru,

Sanker,

Naureen

et al. 2023

Clinical Case Reports

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Key Clinical MessageAn uncommon form of CNS tuberculosis called non‐osseous IDEM tuberculoma frequently results from paradoxical drug interactions. It should be considered one of the differentials when patients receiving ATT experience acute neurological impairment.AbstractTuberculoma affecting the spinal cord is a rare condition in modern times. The occurrence of non‐osseous intradural tuberculosis, specifically in the spine, is even more exceptional. In fact, it is uncommon to encounter an intradural extramedullary tuberculous granuloma that lacks radiological indications of vertebral involvement, especially within the thoracic region. We present a case of a patient with a neurological deficit caused by a non‐osseous intradural tuberculoma in the thoracic region, without any associated bone involvement. The patient experienced a gradual deterioration of neurological function. An MRI of the thoracic spine revealed the presence of a tuberculoma located intradurally, extramedullary, and juxtamedullary of the T5 vertebra. The compression of the spinal cord resulted in paraparesis which was worsening to paraplegia. A D4–D6 laminectomy and microsurgical excision were performed under intraoperative neurophysiological monitoring (IONM), and the patient showed clinical recovery. Excellent clinical outcomes were achieved. However, it is crucial to consider the possibility of a non‐osseous intradural tuberculoma as a rare condition when encountering a SOL, particularly in patients with a history of tuberculosis and spinal cord compression. In cases where a progressing neurological deficit is present, a combination of surgical intervention and anti‐tuberculous treatment should be considered as the optimal approach.

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Isolated extradural tuberculous granuloma of the cervical spine: a case report

Cited by 5 publications

References 22 publications

Concurrent Spinal Epidural Tubercular and Pyogenic Abscess of Cervical Spine without Bony Involvement

Concurrent Spinal Epidural Tubercular and Pyogenic Abscess of Cervical Spine without Bony Involvement

Outcome assessment in conservatively managed patients with cervical spine tuberculosis

Non‐osseous intradural tuberculoma of the thoracic spine with compressive myelopathy

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