Unusual forms of spinal tuberculosis.

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Radiology

Background:

• Tuberculosis (TB) incidence is rising globally, with children being a vulnerable population.
• Central nervous system (CNS) TB is a severe, life-threatening complication, affecting approximately 10% of TB patients.
• Pediatric CNS TB requires careful diagnosis due to its potential severity.

Observation:

• Four pediatric cases with unusual spinal tuberculosis were analyzed.
• Presentations included TB arachnoiditis, intramedullary spinal cord tuberculoma, tuberculous spondylitis of the odontoid peg, and tuberculous extradural abscess.
• These cases demonstrate varied anatomical involvement within the spinal compartment.

Findings:

• Spinal TB can manifest in the intramedullary, extramedullary intrathecal, or extrathecal vertebral compartments.
• Tuberculosis arachnoiditis, abscess, and spondylitis represent distinct patterns of spinal TB involvement.
• Unusual imaging findings are common in pediatric spinal TB.

Implications:

• Recognizing diverse spinal TB presentations is crucial for timely diagnosis in children.
• Advanced imaging interpretation is key to identifying these rare forms of pediatric TB.
• Understanding the anatomical compartments affected by spinal TB aids in treatment planning and prognosis.