Surgery for intramedullary tuberculoma of the spinal cord: report of 2 cases

Muthukumar, Natarajan; Govindaraju, Venkatesh; Senthilbabu, Suyambu; Rajbaskar, Rajamariappan

doi:10.1016/j.surneu.2005.10.024

Cited by 53 publications

(74 citation statements)

References 31 publications

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“…We conclude that even with the decreased stability caused by resection of the zygapophyseal and costotransverse joints, the final outcome of our approach was satisfying. It has been suggested that removing the TB focus using the posterior approach could cause intraspinal infection and central nervous system complications of TB infection, such as TB meningitis [8,16]. Results obtained from this study showed that no patients had TB meningitis, consistent with the other efforts reports [10].…”

Section: Discussionsupporting

confidence: 88%

A clinical study of internal fixation, debridement and interbody thoracic fusion to treat thoracic tuberculosis via posterior approach only

Zhang

Huang

Guo

et al. 2011

International Orthopaedics (SICOT)

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Purpose We evaluated the clinical efficacy and feasibility of one-stage posterior internal fixation, debridement and interbody thoracic fusion in the treatment of thoracic tuberculosis. Methods Sixty adult patients with monosegmental thoracic tuberculosis were studied retrospectively: 34 men and 26 women with an average age of 37.5 years. Operating time, blood loss, time in bed, complications, neurological function, rate of deformity correction and rate of interbody fusion were investigated. Results All cases were followed up for 27.5 months on average. Average mean operating time was 251 min, evaluated blood loss during operation 780 ml, rate of kyphosis correction 79%, corrected kyphosis angle 25°and loss of corrected angle 1.2°. Patients whose neurological function improved accounted for 90.1%. Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) decreased to normal levels three months after operation. The rate of bone fusion was 100%, with a 100% cure rate. No severe complications or spinal cord injury occurred. Conclusions This approach can successfully remove the focus of tuberculosis with complete interbody thoracic fusion after operation, which restores spinal stability.

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Section: Discussionsupporting

confidence: 88%

A clinical study of internal fixation, debridement and interbody thoracic fusion to treat thoracic tuberculosis via posterior approach only

Zhang

Huang

Guo

et al. 2011

International Orthopaedics (SICOT)

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“…Recent study suggested that an early surgical intervention is also important for improving the treatment of IMT, particularly in patient with profound neurological deficits. 4 One-third of patients with IMT may show only signs of spinal-cord compression, but no symptoms of systemic tuberculosis. 5 As the diagnosis of IMT is usually difficult and inconclusive, the needed surgical and pharmacological treatment can be significantly delayed or neglected.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary thoracic tuberculoma

Liu

Wang

et al. 2009

Spinal Cord

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Case report: A 42-year-old Chinese man presented with the complaints of weakness of the lower extremities and urinary retention. Neurological examinations confirmed the motor dysfunction of the lower extremities and hypesthesia in areas below the T8 dermatome. Results from laboratory studies were normal and X-ray over the chest and thoracolumbar spine showed no signs of tuberculosis. However, the magnetic resonance imaging (MRI) scan detected a ring-enhancing intramedullary lesion at the T6-7 intervertebral level. The condition was diagnosed as intramedullary glioma. A neurosurgical resection was carried out, and the pathological examination following the surgery confirmed the tubercular lesion. The patient was treated with antituberculous therapy after the surgery and resulted in a satisfactory recovery. Conclusion: Intramedullary spinal tuberculoma (IMT) is rare, and the diagnosis for IMT is often difficult and inconclusive, especially in patients without symptoms of systemic tuberculosis. Although the management of IMT remains challenging, our report suggests that the combination of microsurgical resection and antituberculous chemotherapy may represent an effective treatment strategy for IMT.

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“…Lors de la dernière décennie, peu de cas ont été décrits (Muthukumar et al, 2006 ;Li et al, 2006 ;Torii et al, 2004 ;Ibahioin et al, 2004 ;Chagla et al, 2007 ;Skoglund et Nilsson, 2006 ;Lin et al, 2006). Les cas décrits étaient pour la plupart dans des pays émergents où la prévalence de la maladie tuberculeuse est beaucoup plus forte que dans les pays dits industrialisés.…”

Section: Discussionunclassified

“…Les prélèvements bactériologiques sont le plus souvent négatifs et le diagnostic est réalisé sur le prélèvement anatomopathologique qui objective le traditionnel granulome épithélioïde et gigantocellulaire. Dans certains cas, les traitements antibiotiques antituberculeux ont été débutés sur des tableaux extrêmement typiques, mais l'absence de chirurgie préalable n'a pas permis d'amélioration notable, nécessitant une intervention secondaire plus tardive, avec une améliora-tion fonctionnelle moins bonne (Muthukumar et al, 2006). On retrouve une lésion intradurale, le plus souvent intramédullaire, sans plan de clivage, avec une attache méningée forte, plus ou moins associée à un abcès intradural.…”

Section: Discussionunclassified

Tuberculose intramédullaire. À propos d’un cas

et al. 2008

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Neurological symptoms of tuberculosis are rare, even if there this pathology has been on the rise for a number of years because of HIV. Intramedullary tuberculoma is an exceptional location. We report the case of a patient with no HIV or immunodepression symptoms with intramedullary tuberculoma, revealed by a clinical presentation of insidious onset of myelopathy. We will discuss the diagnosis, treatment and clinical functional follow-up. The optimal treatment seems to be a combination of microsurgical resection and antibiotic therapy. © 2008 Elsevier Masson SAS. Tous droits réservés. RésuméLes manifestations neurologiques de la tuberculose restent rares, même si ces dernières années ont été marquées par une augmentation de ces pathologies, du fait, notamment, de la pandémie du VIH. Le tuberculome intramédullaire reste une localisation exceptionnelle. Nous rapportons ici le cas d'un patient adulte non séropositif pour le virus VIH et non immunodéprimé présentant un tuberculome intramédullaire, découvert devant un tableau de compression médullaire lente. Nous discuterons le diagnostic radiologique, la nécessité ou non d'un traitement chirurgical, ainsi que les suites cliniques et, notamment, fonctionnelles. Notre expérience nous porte à croire que l'approche combinée de la chirurgie et de l'antibiothérapie paraît être la meilleure alternative.

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Surgery for intramedullary tuberculoma of the spinal cord: report of 2 cases

Cited by 53 publications

References 31 publications

A clinical study of internal fixation, debridement and interbody thoracic fusion to treat thoracic tuberculosis via posterior approach only

A clinical study of internal fixation, debridement and interbody thoracic fusion to treat thoracic tuberculosis via posterior approach only

Intramedullary thoracic tuberculoma

Tuberculose intramédullaire. À propos d’un cas

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