Korean J Spine.  2013 Jun;10(2):97-100. 10.14245/kjs.2013.10.2.97.

Tuberculous Spondylitis after Percutaneous Vertebroplasty: Misdiagnosis or Complication?

• Kang JH
• Kim HS
• Kim SW

• KMID: 1412550
• DOI: http://doi.org/10.14245/kjs.2013.10.2.97

Abstract

So far, there have been few previous reports of tuberculous spondylitis occurring after percutaneous vertebroplasty. We report an unusual case of tuberculous spondylitis diagnosed after percutaneous vertebroplasty in a patient who had a history of pulmonary tuberculosis for the first time. A 58-year-old woman, who had a history of complete recovery from pulmonary tuberculosis six years previously, was hospitalized due to severe back pain after a fall. Radiological studies revealed a fresh compression fracture at the T12 thoracic vertebra. The back pain improved dramatically, and the patient was discharged two days after the vertebroplasty. However, cold sweats and a low grade fever with severe back pain developed four weeks after the procedure. Magnetic resonance imaging revealed a severe kyphosis and the T11-T12 disc space had collapsed with heterogeneous signal intensity. The results of the culture of the biopsy specimens were negative, and did not lead to identification of the causative micro-organism. However, the polymerase chain reaction for Mycobacterium tuberculosis was positive. Treatment for tuberculous spondylitis was started and she underwent posterior fusion and instrumentation from T9-L2 after the markers for infection returned to normal. After surgical intervention, the pain improved and the kyphotic deformity was corrected.

Keyword

Tuberculous spondylitis; Percutaneous vertebroplasty

MeSH Terms

Back Pain
Biopsy
Cold Temperature
Congenital Abnormalities
Dental Cements
Diagnostic Errors
Female
Fever
Fractures, Compression
Humans
Kyphosis
Magnetic Resonance Imaging
Mycobacterium tuberculosis
Polymerase Chain Reaction
Spine
Spondylitis
Sweat
Tuberculosis, Pulmonary
Vertebroplasty
Dental Cements