Spinal Tuberculosis Mimicking Failed Back Surgery

Am J Case Rep. 2018 Mar 6:19:249-253. doi: 10.12659/ajcr.907409.

Abstract

BACKGROUND The aim of this study was to draw attention to rare spinal infections in recurrent failed spinal surgeries. CASE REPORT A 59-year-old female was admitted to the hospital for back pain, which was assessed as a 9 on the visual analogue scale (VAS); the patient reported tiredness and night sweats. She had an operation for L3-4 far lateral disc herniation four years ago. Then another operation for L4-5 disc herniation six months ago and immediately three months later she has an operation with L3-4-5 fixation again. She had hypothyroidism, diabetes mellitus, and hypertension. Her daughter was cured of pulmonary tuberculosis 20 years ago. We performed an operation by L4-5 discectomy; all granulation formation with inflammatory processes were debrided and irrigated with antibiotics at levels of L3-5. The old fixation was controlled and replaced. Her back pain improved immediately after surgery; she had a score of 2 on the VAS. Two days after her surgery, our Infection Disease Department reported acid resistant bacillus (ARB+) in samples and began anti-tuberculosis medication. CONCLUSIONS Spinal infections should always be taken into consideration in recurrent failed back surgeries.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / administration & dosage
  • Diagnosis, Differential
  • Diskectomy / adverse effects*
  • Diskectomy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Degeneration / diagnosis*
  • Intervertebral Disc Degeneration / diagnostic imaging
  • Intervertebral Disc Degeneration / surgery*
  • Intervertebral Disc Displacement / diagnosis*
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / surgery*
  • Low Back Pain / diagnosis
  • Low Back Pain / etiology
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification*
  • Pain Measurement
  • Reoperation / methods
  • Risk Assessment
  • Severity of Illness Index
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / microbiology*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Tuberculosis, Spinal / diagnosis*
  • Tuberculosis, Spinal / drug therapy

Substances

  • Antitubercular Agents

Supplementary concepts

  • Intervertebral disc disease