Korean J Spine.  2012 Mar;9(1):28-31. 10.14245/kjs.2012.9.1.28.

Late Onset Tuberculous Spondylitis Following Kyphoplasty: A Case Report and Review of the Literature

• Kim HJ
• Shin DA
• Cho KG
• Chung SS

• KMID: 2288366
• DOI: http://doi.org/10.14245/kjs.2012.9.1.28

Abstract

A 76-year-old woman with compression fracture of L1 underwent percutaneous balloon kyphoplasty using polymethyl methacrylate. Three years after kyphoplasty of L1, the patient was readmitted with severe low back pain. Magnetic resonance imaging revealed progressive collapse of L1 vertebra and new compression fracture at T12. There were no signs of infection. As conservative treatment failed, combined surgery consisting of anterior corpectomy of T12 and L1, interposition of a titanium mesh cage filled with autologous rib graft, and anterior instrumentation of T11-L2 was performed. Histologic examination showed granulomatous inflammation surrounding the cement. Polymerase chain reaction and culture of the specimen confirmed the diagnosis of tuberculosis. The anti-tuberculous medications were administered for 10 months, and the patient recovered without any sequelae. Tuberculous spondylitis should be included in the differential diagnosis of spondylitis after cement augmentation. If conservative antibiotic therapy fails, resection of the infected bone-cement complex is indicated.

Keyword

Cementoplasty; Vertebroplasty; Kyphoplasty; Complications; Infection; Spinal tuberculosis

MeSH Terms

Aged
Cementoplasty
Diagnosis, Differential
Female
Fractures, Compression
Humans
Inflammation
Kyphoplasty
Low Back Pain
Magnetic Resonance Imaging
Polymerase Chain Reaction
Polymethyl Methacrylate
Ribs
Spine
Spondylitis
Titanium
Transplants
Tuberculosis
Tuberculosis, Spinal
Vertebroplasty
Polymethyl Methacrylate
Titanium