Binsaeedu Abdullah S, Sadi Nehal V, Yusuf Sagal, Yusuf Salma, Youshay Humayun
Internal Medicine, Alfaisal University College of Medicine, Riyadh, SAU.
Internal Medicine, Saint James School of Medicine, Chicago, USA.
Cureus. 2023 Sep 8;15(9):e44881. doi: 10.7759/cureus.44881. eCollection 2023 Sep.
Spinal tuberculosis (TB), also known as Pott's disease, is a severe form of extrapulmonary TB that affects the vertebral bodies and intervertebral discs. While the typical presentation involves the contiguous involvement of multiple vertebrae, atypical forms, such as non-contiguous multilevel spinal TB (NMLST), can occur. However, diagnosing spinal TB poses challenges due to its gradual onset, nonspecific symptoms, and varying imaging results. The timely diagnosis and treatment of spinal TB are critical to prevent serious consequences, including vertebral damage, irreversible neurological impairment, or even death. In this report, we present the case of a 58-year-old South Asian female who presented with several months of back pain, fatigue, and weight loss. Despite initially negative TB test results, spinal magnetic resonance imaging (MRI) raised suspicion of NMLST, which was later confirmed by bone biopsy. This case highlights the complexities of diagnosing and managing atypical spinal TB presentations while discussing the case findings and reviewing relevant research.
脊柱结核，也称为波特氏病，是一种严重的肺外结核形式，会影响椎体和椎间盘。虽然典型表现为多个椎体连续受累，但也可能出现非典型形式，如非连续性多节段脊柱结核（NMLST）。然而，由于脊柱结核起病隐匿、症状不具特异性且影像学结果各异，其诊断颇具挑战。脊柱结核的及时诊断和治疗对于预防严重后果至关重要，这些后果包括椎体损伤、不可逆的神经功能损害甚至死亡。在本报告中，我们介绍了一名58岁南亚女性的病例，该患者出现了数月的背痛、疲劳和体重减轻。尽管最初结核检测结果为阴性，但脊柱磁共振成像（MRI）引发了对NMLST的怀疑，后来经骨活检得以证实。本病例突出了诊断和管理非典型脊柱结核表现的复杂性，同时讨论了病例 findings 并回顾了相关研究。 （注：原文中“findings”未翻译，可能是拼写有误，推测可能是“findings”，意为“发现、结果”，这里直接保留英文是因为不清楚具体准确意思，需结合更多背景信息来准确翻译。）
