Spinal Tuberculosis Mimicking Failed Back Surgery
Özdoğan S, Yaltırık CK, Düzkalır AH, Demirel N, Kaya M, Atalay B
The American journal of case reports · 2018-03
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.
MeSH terms
- Humans
- Mycobacterium tuberculosis
- Tuberculosis, Spinal
- Surgical Wound Infection
- Low Back Pain
- Antitubercular Agents
- Diagnosis, Differential
- Tomography, X-Ray Computed
- Pain Measurement
- Treatment Outcome
- Diskectomy
- Reoperation
- Severity of Illness Index
- Risk Assessment
- Follow-Up Studies
- Middle Aged
- Female
- Intervertebral Disc Displacement
- Intervertebral Disc Degeneration