A case of spinal tuberculosis presenting with cauda equina syndrome

Area of Science:

• Neurology
• Infectious Diseases
• Radiology

Background:

• Tuberculosis (TB) of the central nervous system is rare, but spinal TB constitutes 50% of these cases.
• Spinal TB presents with symptoms like back pain, weakness, and deformities, and can lead to cauda equina syndrome due to Mycobacterium tuberculosis infection.

Observation:

• A 28-year-old female presented with subacute low back pain, progressive lower limb weakness, and sudden loss of bladder/bowel control.
• MRI revealed an intraosseous collection with spondylodiscitis at L4, indicative of spinal TB.

Findings:

• Magnetic resonance imaging (MRI) is crucial for detecting spinal TB, identifying vertebral involvement, disk destruction, abscesses, and deformities.
• Antituberculous therapy is the primary treatment, with surgery indicated for large abscesses, severe deformities, or neurological deficits.

Implications:

• A combined approach of laminectomy, abscess drainage, and antitubercular therapy resolved the patient's condition.
• Early diagnosis and appropriate management of spinal TB are essential for a favorable prognosis and preventing long-term neurological damage.