Sridhar Krishnamurthy, Krishnan Prasad
Department of Neurosurgery, National Neurosciences Center, Calcutta, India.
Neurol India. 2009 Jul-Aug;57(4):483-5. doi: 10.4103/0028-3886.55600.
Spinal tuberculosis most commonly presents as a paradiscal lesion involving the disc space and adjacent vertebral bodies. Atypical forms of spinal tuberculosis have been described and are most often a result of posterior element involvement. The authors report a patient, who presented with complete posterior migration of an intact vertebral body, a complication of spinal tuberculosis that has not been reported till date. A 12-year-old girl with history of pulmonary tuberculosis presented with progressive paraparesis and back pain. Plain X-rays and MRI revealed that the L2 vertebral body had migrated posteriorly into the spinal canal, without significant movement of the posterior elements. The vertebral body was normal, with no erosion or bone loss. However, bilateral pedicle and facet joint involvement was seen. The neural elements were decompressed through an anterolateral retroperitoneal approach and the spine reconstructed. The authors present this rare manifestation of spinal tuberculosis and discuss the possible mechanisms of this presentation.
脊柱结核最常见的表现是累及椎间盘间隙和相邻椎体的椎间隙病变。非典型脊柱结核已有描述，最常见的原因是后部结构受累。作者报告了1例患者，该患者出现完整椎体向后完全移位，这是一种迄今尚未见报道的脊柱结核并发症。一名有肺结核病史的12岁女孩出现进行性双下肢轻瘫和背痛。X线平片和磁共振成像（MRI）显示，L2椎体向后移位至椎管内，后部结构无明显移位。椎体正常，无骨质侵蚀或骨质丢失。然而，可见双侧椎弓根和小关节受累。通过腹膜后外侧入路对神经结构进行减压并重建脊柱。作者介绍了这种罕见的脊柱结核表现，并讨论了其可能的发生机制。
