Thoracic spinal tuberculosis in a 2.5-year-old child treated by surgical procedure with a transthoracic approach: a case report

Abstract

Introduction and importance: Pott’s disease is a form of extrapulmonary tuberculosis (TB) and has a global increase in incidence. The diagnosis should be made early to avoid neurological deficiency or deformity of the spine. Case presentation: A 2-year-old and 6-month-old boy was admitted with fever and unspecific generalized pain, the examination revealed mild hyperreflexia in the lower extremities, isotope scan showed increased uptake in the T8 vertebra. MRI demonstrated destruction in the T8 vertebra with kyphotic deformity and abscess anterior to T7, T8, and T9 levels with an epidural abscess at the T8 level extending to the spinal canal and compressing the spinal cord. The patient underwent a surgical procedure with a transthoracic approach, the decompression of the spinal canal was performed through T8 corpectomy, the reduction of kyphosis was performed and the internal fixation with a dynamic cylinder and lateral titanium plate was carried out. Microbiologic examination suggests Mycobacterium tuberculosis. Clinical discussion: Pott’s disease (spinal TB) is extremely rare in the young children population, and surgical treatment is reported only in a few reports, and it is considered a technical challenge. There are several surgical approaches during childhood, for upper thoracic spinal TB, the posterior approach is easy, minimally invasive, safe, reliable, and effective. But it had the worst outcomes. In contrast, the anterior approach provides direct access to the lesions. Conclusion: More research are needed to detect the best choice in the management of thoracic spinal TB in children.