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A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
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Lumbar Spinal Tuberculosis Presenting as Abdominal Pain: Case Report
Zhaoyu Ba1, Zhiyao Yong1, Weidong Zhao1
1Spine Department, Shanghai East Hospital, Shanghai, China.
Surgery Journal (New York, N.Y.)
|August 22, 2017
Summary
Tuberculosis spondylitis can present atypically. This case highlights lumbar spinal tuberculosis mimicking malignancy, with abdominal pain as the primary symptom, requiring prompt diagnosis and treatment.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Radiology
Background:
- Spinal tuberculosis (tuberculosis spondylitis) remains a diagnostic challenge despite its long history.
- Atypical presentations can mimic other serious conditions, including malignancy.
- Early recognition is crucial for effective management and preventing complications.
Observation:
- A 50-year-old woman presented with 6 months of chronic, intermittent abdominal pain without typical tuberculosis symptoms.
- Magnetic resonance imaging revealed extensive destruction of lumbar vertebrae (L3-L5), spinal canal invasion, and a large psoas abscess.
- Elevated inflammatory markers (CRP 130 g/L, ESR 165 mm/h) supported an infectious process.
Findings:
- A diagnosis of lumbar spinal tuberculosis presenting as abdominal pain was confirmed.
- The patient underwent surgical debridement and spinal reconstruction after initial antituberculosis treatment.
- A combined anterior and posterior surgical approach was utilized for optimal stability.
Implications:
- This case underscores the importance of considering spinal tuberculosis in patients with unexplained abdominal pain, especially with elevated inflammatory markers.
- Aggressive surgical intervention combined with antituberculosis therapy can lead to successful outcomes.
- Timely diagnosis and multidisciplinary management are key to improving patient recovery and preventing neurological deficits.
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