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Updated: Jul 7, 2026
06:23
Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
Published on: May 23, 2021
Tuberculous spondylitis in elderly Japanese patients
Yuki Maeda1, Kazutaka Izawa, Takaharu Nabeshima
1Department of Orthopaedic Surgery, Osaka Minami Medical Center, Kawachinagano, Osaka, Japan.
Summary
Diagnosing tuberculous spondylitis in elderly patients is challenging due to atypical symptoms and masked radiographic changes. Early consideration in differential diagnosis for elderly back pain is crucial.
Area of Science:
- Medical Imaging
- Infectious Diseases
- Geriatrics
Background:
- Tuberculous spondylitis incidence is rising, particularly in the elderly population in Japan.
- Elderly patients present unique challenges for diagnosis and management of spinal tuberculosis.
Purpose of the Study:
- To describe clinical features and diagnostic imaging findings in elderly patients with tuberculous spondylitis.
- To improve diagnostic accuracy for tuberculous spondylitis in geriatric populations.
Main Methods:
- Retrospective review of 23 patients over 70 years old diagnosed with tuberculous spondylitis.
- Analysis of clinical signs, symptoms, laboratory tests (ESR, WBC, CRP), plain X-rays, and MRI findings.
Main Results:
- Common symptoms included local pain (83%) and neurological deficits (57%).
- Fever was present in 30% of patients; C-reactive protein was low (<1.0 mg/dl) in 26%.
- Radiography showed atypical changes in some cases, including single-vertebra involvement.
Conclusions:
- Tuberculous spondylitis diagnosis in the elderly is difficult due to atypical symptoms and masked radiographic findings.
- Degenerative changes in the elderly can obscure signs of spinal tuberculosis.
- Consider tuberculous spondylitis in elderly patients with back pain, especially in regions with a history of tuberculosis.
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