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Unusual spinal tuberculosis with cord compression in an infant

Inn-Chi Lee1, Yeak-Wun Quek, Shih-Ming Tsao

  • 1Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan. y610@mercury.csmu.edu.tw

Journal of Child Neurology
|February 9, 2010
PubMed

Insights

Tuberculosis of the spine is rare in infants, but this case highlights its potential for causing spinal cord compression. Early diagnosis and treatment are crucial for recovery in pediatric spinal abscesses.

Area of Science:

  • Pediatric Neurosurgery
  • Infectious Diseases
  • Spinal Surgery

Background:

  • Spinal abscesses are uncommon in pediatric populations, with bacterial infections like Staphylococcus aureus being the most frequent cause.
  • Tuberculosis (TB) is a less common but significant etiology of spinal abscesses, particularly in endemic regions.

Observation:

  • A 13-month-old child presented with a month of progressive right-sided hemiparesis, predominantly affecting the leg.
  • Cervical spine magnetic resonance imaging revealed an abscess with associated bony destruction and significant spinal cord compression.

Findings:

  • Surgical decompression and laminectomy were performed emergently.
  • Histopathology and cultures confirmed Mycobacterium tuberculosis as the causative agent of the spinal abscess.
  • The child demonstrated significant functional recovery, initially requiring a walker and later achieving independent ambulation after 12 months of antituberculosis therapy.

Implications:

  • Spinal tuberculosis should be strongly considered in pediatric patients presenting with spinal cord compression symptoms and imaging evidence of an extraspinal abscess.
  • Prompt neurosurgical intervention combined with appropriate antituberculosis treatment is essential for optimizing neurological outcomes and functional recovery in children with spinal TB.

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