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A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
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Paediatric tubercular spinal abscess involving the dorsal, lumbar and sacral regions and causing spinal cord

Elena Bozzola1, Mauro Bozzola, Andrea Magistrelli

  • 1Department of Pediatric, Pediatric and Infectious Diseases Unit, Bambino Gesu Childrens Hospital, IRCCS, Rome; Department of Internal Medicine, University of Pavia, Pavia; Department of Radiology, Bambino Gesu Childrens Hospital, IRCCS, Rome, Italy.

Le Infezioni in Medicina
|September 7, 2013
PubMed

Insights

Pediatric spinal tuberculosis is rare, even after Bacillus Calmette-Guerin vaccination. Early surgical decompression is crucial for spinal cord compression to prevent permanent damage.

Area of Science:

  • Pediatric spinal tuberculosis
  • Infectious disease epidemiology
  • Neurosurgery

Background:

  • Spinal tuberculosis (TB) is uncommon in children, representing only 5% of pediatric TB cases.
  • Bacillus Calmette-Guerin (BCG) vaccination is often administered to infants to prevent severe forms of TB.

Observation:

  • A pediatric case presented with lymphadenitis without pulmonary TB, despite a history of BCG vaccination.
  • The patient progressed to spinal tuberculosis with significant cord compression despite standard anti-TB treatment.

Findings:

  • Urgent surgical decompression via laminectomy (D3-D5) and abscess flushing was required to relieve spinal cord and cauda equina compression.
  • Diagnosis of TB should be considered in children with concerning symptoms, irrespective of BCG vaccination status.

Implications:

  • This case highlights the importance of considering spinal TB in pediatric patients, even with prior BCG vaccination.
  • Prompt surgical intervention for spinal cord compression in TB is vital to avert irreversible neurological deficits.

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