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Tuberculosis in Childhood and Pregnancy
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Lindsay H. Cameron, Jeffrey R. Starke
Most cases of bone tuberculosis occur in the vertebrae causing tuberculosis of the spine, known as Pott's disease.84 Although any vertebral body can be involved, there is a predilection for the lower thoracic and upper lumbar vertebrae. Involvement of two or more vertebrae is common; they usually are continuous but there may be skip areas between lesions. The infection is in the body of the vertebra leading to bony destruction and collapse. The usual progression of tuberculous spondylitis is from initial narrowing of one or several disc spaces to collapse and wedging of the vertebral body with subsequent angulation of the spine (gibbus) or kyphosis. The infection may extend out from the bone causing paraspinal (Pott's), psoas, or retropharyngeal abscess. The most frequent clinical signs and symptoms of tuberculous spondylitis in children are low-grade fever, irritability and restlessness (especially at night), back pain usually without significant tenderness, and abnormal positioning and gait or refusal to walk. Rigidity of the spine may be caused by profound muscle spasm resulting from the child's involuntary effort to immobilize the spine.
Current trend in kyphoplasty for osteoporotic vertebral fractures
Published in Peter V. Giannoudis, Thomas A. Einhorn, Surgical and Medical Treatment of Osteoporosis, 2020
Kalliopi Alpantaki, Georgios Vastardis, Alexander G. Hadjipavlou
Postoperative infection is a rare but devastating complication of kyphoplasty. A few cases have been reported in the literature (110,132,141–147). Ongoing back pain and/or neurological complication are the predominant presenting symptoms. Staphylococcus aureus is the most common pathogen (132,148). Tuberculous spondylitis has also been reported (149). Infection after cementoplasty procedure is likely related to a prior systemic infection, an immunocompromised host, or intraoperative contamination. Preoperative prophylactic antibiotic administration is recommended. Cement mixed with antibiotics has also been recommended in the cases with a previous infection or in immunocompromised patients (150). In case of concurrent infection, the procedure must be postponed until the infection is controlled. Cementoplasty infection can be treated conservatively with a course of antibiotics based on antibiotic sensitivity testing (144). Infection refractory to conservative treatment or recurrent infection should be treated with corpectomy, cement removal, and instrumented spinal reconstruction (150).
Test Paper 6
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Tuberculous spondylitis is diagnosed in a 44-year-old woman with progressive neurological deficit with severe discovertebral destruction and compression of the spinal cord at the T11–12 level on sagittal T2W & STIR MR images. Post-contrast images show a rim-enhancing anterior abscess that does not encase the intercostal arteries. All of the following features are more likely to represent tuberculosis spondylitis compared to pyogenic spondylitis, except: Subligamentous spreadThree or more vertebral level involvementSkip lesionsHomogenous enhancement of the discParaspinal calcification
One-stage posterior approach for treating multilevel noncontiguous thoracic and lumbar spinal tuberculosis
Published in Postgraduate Medicine, 2019
Rui-song Chen, Xin Liao, Mo-liang Xiong, Feng-rong Chen, Bo-wen Wang, Jian-ming Huang, Xiao-lin Chen, Gang-hui Yin, Hao-yuan Liu, Da-di Jin
Anti-TB chemotherapy is still the main treatment for tuberculous spondylitis. However, this type of conservative treatment for kyphotic deformities cannot completely prevent possible progression, and patients need to be completely bedridden to avoid vertebral collapse or to alleviate pain caused by compression of nerve root [6]. With the remarkable progress regarding the treatment of spinal TB in recent years, surgical treatment has become an effective method to correct deformities and stabilize spinal instability [7]. However, there were relatively few reports on MNST management. In this study, a series of patients with MNST underwent a one-stage debridement and decompression, combined with an intervertebral fusion and posterior instrumentation.
Tuberculous flexor tenosynovitis around the wrist causing massive tendon disruption: a case report
Published in Modern Rheumatology Case Reports, 2019
Mitsuhiko Takahashi, Tetsuya Hirano, Kenji Kondo, Tadashi Mitsuhashi
Tuberculosis (TB) is still a devastating infectious disease in Japan, which is classed as a middle TB-burden country [1]. The most frequently affected system in TB is the respiratory system (pulmonary TB). Tuberculous spondylitis is the most common presentation of musculoskeletal tuberculous infection, followed by peripheral arthritis and peripheral osteomyelitis as the second and third common presentations, respectively [2]. It is reported that tuberculous tenosynovitis is infrequent in musculoskeletal tuberculous infection [2,3], which in general does not present with definitive signs or symptoms of infection, unlike other pyogenic diseases, and thus often leads to delayed diagnosis or even misdiagnosis.