Department of Orthopedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Department of Orthopedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
BMJ Case Rep. 2020 May 14;13(5):e234246. doi: 10.1136/bcr-2020-234246.
It is uncommon to get lumbosacral junction deformity due to tuberculosis. Lumbosacral junction alignment is of paramount importance in maintaining global sagittal balance. In this case report, we present a case of a 42-year-old woman with multidrug-resistant tuberculosis of lumbosacral spine with complete destruction of L3, L4 and L5 vertebra with partial destruction of L2 and S1 vertebra leading to significant shortening and lumbosacral kyphosis. The patient had severe axial low back pain, inability to sleep in supine position due to deformity and difficulty in walking due to loss of spinal alignment. The patient was treated with 6 weeks of antituberculous drugs followed by all posterior decompression with instrumentation from D10 to S2 with a reconstruction of anterior vertebral bodies with the help of an expandable cage. Antituberculous treatment was continued for 18 months. At present, the patient is asymptomatic with no neurological deficit and has completed 3.5 years of regular follow-up.
由于结核病而导致腰骶关节畸形并不常见。腰骶关节对线对于维持整体矢状面平衡至关重要。在本病例报告中，我们介绍了一位 42 岁女性，患有腰骶脊柱多药耐药性结核，L3、L4 和 L5 椎体完全破坏，L2 和 S1 椎体部分破坏，导致明显缩短和腰骶角后凸。患者有严重的轴向腰痛，由于畸形而无法仰卧入睡，由于脊柱对线丢失而行走困难。患者接受了 6 周的抗结核药物治疗，随后进行了从 D10 到 S2 的所有后路减压和器械固定，在可扩张 cage 的帮助下重建了前椎体。抗结核治疗持续了 18 个月。目前，患者无症状，无神经功能缺损，已完成 3.5 年的定期随访。
