Department of Spine Surgery, Ganga Hospital, Coimbatore 641043, Tamil Nadu, India.
Spine J. 2010 Mar;10(3):e1-4. doi: 10.1016/j.spinee.2009.12.004. Epub 2010 Jan 25.
Posterior element tuberculosis is rare accounting for only 3% to 5% of all spinal tuberculosis. To our knowledge, no case of isolated facet joint tuberculosis with coronal decompensation has been reported in literature so far.
The purpose of this study was to describe a case of tuberculous arthritis of the lumbar facet joint and its effect on coronal balance of the spine.
The study design was a case report.
A 14-year-old boy presented with a 3-month history of back pain without radiation and with normal neurological findings. Computed tomography and magnetic resonance imaging showed destruction of the right L4-L5 facet joint with L5-S1 spondylolytic listhesis. Despite 2 months of antitubercular medication after a core biopsy confirmation of L4-L5 facet tuberculosis, there was progression of coronal decompensation of the spine with severe pain. Instrumentation with intertransverse fusion was done as a secondary procedure.
The patient was completely relieved of symptoms after instrumented fusion along with antitubercular medication.
Isolated lumbar facet joint tuberculosis is a rare entity with a potential for coronal decompensation of the spine, which makes early instrumented fusion with antitubercular medication a viable treatment modality.
后部脊柱结核很少见，仅占所有脊柱结核的 3%至 5%。据我们所知，目前文献中尚无孤立的关节突结核伴冠状失代偿的报道。
本研究旨在描述一例腰椎小关节结核及其对脊柱冠状平衡的影响。
本研究设计为病例报告。
一名 14 岁男孩因背部疼痛 3 个月就诊，无放射痛，神经检查正常。CT 和磁共振成像显示右侧 L4-L5 关节突关节破坏，L5-S1 脊椎滑脱。尽管在 L4-L5 关节突结核的核心活检确诊后进行了 2 个月的抗结核药物治疗，但脊柱冠状失代偿仍有进展，出现严重疼痛。在进行二次经横突间融合固定术之前，进行了核心活检以确诊结核。
在进行仪器固定融合术并使用抗结核药物治疗后，患者的症状完全缓解。
孤立性腰椎小关节结核很少见，可能导致脊柱冠状失代偿，因此早期使用仪器固定融合术联合抗结核药物治疗是一种可行的治疗方法。
