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tb and paraplegia

Suresh Subramani, Ajoy Prasad Shetty, Rishi M Kanna, Shanmuganathan Rajasekaran
Late onset neurological deficit is a rare complication of spinal tuberculosis. Reactivation of the disease and compression by internal gibbus are the common causes for late onset neurological deficit. We report a rare cause of late onset paraplegia in a patient with post tubercular kyphotic deformity. The late onset neurological deficit was due to the adjacent segment degeneration proximal to the kyphotic deformity. Posterior hypertrophied ligamentum flavum and anterior disc osteophyte complex caused the cord compression...
December 2017: Journal of Spine Surgery (Hong Kong)
Yogesh Jain, Gajanan Phutke
Even though 1% of people require palliative and end-of-life care in low-resource situations, it remains an uncharted arena. Yet it is as important as curative care to alleviate suffering. Palliative care is not only a need in cancer and HIV disease; but is needed in a diverse group of illnesses ranging from tuberculosis, renal failures, paraplegia to chronic lung diseases. In a lower resource setting, the gaps in palliation may be the need for more technology and interventions or more healthcare professionals...
October 25, 2017: Indian Journal of Medical Ethics
Nazierhan Shaxika, Z G Sun, H Yuan, H Wang
Objective: To investigate the application of 3D printing technology in the treatment of patients with cervical kyphosis and paraplegia in different segments of the cervical spine after one-stage debridement, bone graft fusion and pedicle screw fixation. Methods: From January 2008 to January 2017, a total of 31 patients with thoracolumbar tuberculosis were treated in the Department of Orthopaedics, the Xinjiang Uygur Autonomous Region people's Hospital.Lesions of the thoracic spine (T1-T4) in 8 cases, (C5-C7) in 10 cases, cervical and thoracic segment in 13 cases, involving a total of 2 cases of vertebral body in 7 cases, 3 cases of vertebral body in 14 cases, 4 cases of vertebral body...
November 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Y W Wong, D Samartzis, K M C Cheung, K Luk
AIMS: To address the natural history of severe post-tuberculous (TB) kyphosis, with focus upon the long-term neurological outcome, occurrence of restrictive lung disease, and the effect on life expectancy. PATIENTS AND METHODS: This is a retrospective clinical review of prospectively collected imaging data based at a single institute. A total of 24 patients of Southern Chinese origin who presented with spinal TB with a mean of 113° of kyphosis (65° to 159°) who fulfilled inclusion criteria were reviewed...
October 2017: Bone & Joint Journal
Yakefu Abulizi, Wei-Dong Liang, Maierdan Maimaiti, Wei-Bin Sheng
The purpose of this study is to determine the efficacy and safety of Smith-Petersen osteotomy combined with anterior debridement and allogenic strut bone grafting for the treatment of active thoracic and lumbar spinal tuberculosis with kyphotic deformity in young children.Spinal tuberculosis is more destructive in young children and often causes severe kyphosis and paraplegia. Despite much progress has been made, surgical treatment is still controversial and technically challenging.From October 2010 to August 2014, 25 children (11 males, 14 females; aged under 6 years) with active thoracic and lumbar spinal tuberculosis treated by Smith-Petersen osteotomy combined with anterior debridement and allogenic strut bone grafting were enrolled in this study...
August 2017: Medicine (Baltimore)
Suresh Subramani, Ajoy Prasad Shetty, Rishi Mugesh Kanna, Rajasekaran Shanmuganathan
Late onset paraplegia is a rare complication of spinal tuberculosis. Disease reactivation and cord compression by internal gibbus are the common causes for neurological deficit. We report a patient with post-tubercular kyphotic deformity in whom the late onset paraplegia is caused by ossified ligamentum flavum above the level of kyphotic deformity. The deficit was attributable to the ossified ligamentum flavum and she recovered completely following posterior decompression and instrumented posterolateral fusion...
April 2017: Journal of Clinical Orthopaedics and Trauma
Qiaoling Ruan, Yimin Zhu, Shu Chen, Liping Zhu, Shu Zhang, Wenhong Zhang
BACKGROUND: Cryptococcus neoformans is frequently present as an opportunistic pathogen mainly affecting immunocompromised populations. Disseminated C. neoformans infection in immunocompetent population is rare and usually involves lung and central nerve system. Cryptococcus from biologic samples can easily grow on routine fungal and bacterial culture media. Besides, cryptococcal latex agglutination test has been established as a reliable diagnostic tool with overall sensitivities of 93-100%...
May 30, 2017: BMC Infectious Diseases
Michael George Zaki Ghali, Visish M Srinivasan, Marc J Kim, Archana Malik
BACKGROUND: Tuberculous involvement of the spinal cord parenchyma is an exceedingly rare clinical entity; even more so is concurrent intracranial tuberculosis (TB). Spinal intramedullary TB presents with a characteristic subacute myelopathy, with slowly progressive paraplegia, sensory deficits, and/or bowel and bladder dysfunction. Diagnosis is strongly suspected with a clinical history of known TB in conjunction with characteristic findings on magnetic resonance imaging. Management involves multiagent antitubercular chemotherapy without or with operative intervention...
October 2017: World Neurosurgery
Yunus Atici, Mehmet Bulent Balioglu, Deniz Kargin, Muhammed Mert, Akif Albayrak, Mehmet Akif Kaygusuz
OBJECTIVE: The aim of this study was to evaluate the complications, efficacy and safety of posterior vertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100°. METHODS: The medical records of 17 patients (mean age 17.9 (range, 9-27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24-64) months. Diagnosis of the patients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients and neurofibromatosis in 3 patients...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
J H Goh, M Fazir, N A Zainal-Abidin, D Amir, M Singh
Spinal tuberculosis is not common in the paediatric age group. Initial clinical features are often vague and non specific until the disease progresses to later stages. We highlight the diagnostic difficulties and management challenges of a complicated extradural tuberculoma with neurological deficits in a very young girl.
July 2016: Malaysian Orthopaedic Journal
Eva M N Wouda, Ymkje Stienstra, Tjip S van der Werf, Huib Kerstjens, Wiel C M de Lange, Maarten Coppes, Jos Kuijlen, Marga Tepper, Onno W Akkerman
BACKGROUND: Spinal tuberculosis (TB) accounts for approximately 1% to 3% of all TB cases and it can cause a wide range of neurological symptoms, from none to a complete spinal cord injury (SCI), resulting in complete paraplegia or tetraplegia. OBJECTIVES: To describe the functional and neurological outcome of SCI caused by TB. METHODS: Retrospective data on the admission period was combined with prospectively collected data on long-term follow-up...
2017: NeuroRehabilitation
J Tayierjiang, N Waresijiang, H Wang
Objective: To evaluate the clinical results of the patients with severe kyphosis and paraplegia in different spine segment due to tuberculosis of thoracic and lumbar had been treated by one stage posterior surgical procedure to debriment of lesion and titian mesh bone fusion with internal fixation by pedicle screw system. Method: From May 2008 to March 2014, there were total 30 patients with severe kyphosis and paraplegia in different spine segment due to tuberculosis of thoracic and lumbar in Department of Orthopaedics, the People's Hospital of Xinjiang Uygur Autonoumy Region...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Emna Toulgui, Sonia Jemni, Samia Frioui, Nadia Lazreg, Sahbi Mtaouaa, Fayçal Khachnaoui
OBJECTIVE: Tuberculous spondylitis, or Pott's disease, is a public health problem in Tunisia, where it occurs as an endemic disease. It is the most common and most severe articular bone tuberculosis. It is responsible for a major handicap because of its location and its destructive nature. This work aims to assess the contribution of rehabilitation for patients with Pott's disease. MATERIAL/PATIENTS AND METHODS: A retrospective study that included 29 patients with Pott's disease and hospitalized in PMR Service...
September 2016: Annals of Physical and Rehabilitation Medicine
Laila Mahir, Soumia Meftah, Siham Zahi, Herman Azanmasso, Fatima Lmidmani, Abdellatif El Fatimi
OBJECTIVE: Tuberculosis of the central nervous system is a major cause of morbidity and mortality in developing countries. Myelitis is the most common manifestation of spinal tuberculosis. OBJECTIVE: we report the epidemiological characteristics, clinical and functional aspects in a group of 14 patients with tuberculous myelitis after functional rehabilitation. MATERIALS/PATIENTS AND METHODS: Over a period of 4 years, 14 cases of tuberculous myelitis were admitted for functional rehabilitation...
September 2016: Annals of Physical and Rehabilitation Medicine
George Sikalengo, Adria Ramirez, Diana Faini, Kim Mwamelo, Manuel Battegay, Levan Jugheli, Christoph Hatz, Klaus Reither, Emilio Letang
BACKGROUND: Extrapulmonary tuberculosis (EPTB) is associated with high rates of morbidity and mortality. Diagnosis of EPTB is challenging in resource-limited settings due to difficulties in obtaining samples, as well as the paucibacillarity of the specimens. Skeletal tuberculosis accounts for 10-35 % of EPTB cases, with vertebral osteomyelitis (Pott's disease) representing 50 % of the cases. We present two cases of suspected Pott's disease, diagnosed through GeneXpert MTB/RIF assay in urine at a rural Tanzanian hospital...
September 26, 2016: BMC Infectious Diseases
Teoman Aydın, Özgür Taşpınar, Yasar Keskin, Müge Kepekçi, Meryem Güneşer, Adil Çamlı, Hakan Seyithanoğlu, Huriye Kızıltan, Ali Hikmet Eriş
BACKGROUND: Tuberculous radiculomyelitis(TBRM) is one of the complications of neurological tuberculosis and includes cases of arachnoiditis, intradural spinal tuberculoma or granuloma, and spinal cord complications of tuberculous meningitis (TBM). Here, we report a case of TBRM which presented with acute paraplegia. CASE DETAILS: Neurological examination on admission revealed flaccid paralysis, bilateral extensor plantar responses, and exaggerated deep tendon reflexes...
July 2016: Ethiopian Journal of Health Sciences
Kush Kumar
PURPOSE: To describe the natural history spinal tuberculosis, classifications and principles of management based upon the grading of the neurological deficit. METHODS: Review of literature was conducted with the aim to provide the clinico-radiological correlation of the natural history of spinal tuberculosis in different stages. Management strategy is developed based upon the severity of the neurological deficit. RESULTS: A five stage natural history of spinal tuberculosis is described...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Z Guo, M Yao, J Wang, K Sun, Z Ji
Objective: This work aims to investigate the efficacy of debridement for paediatric thoracolumbar spinal tuberculosis (TB) by using the anterior approach and the allogeneic bone graft. Methods: The lesions of 16 children diagnosed with thoracolumbar spinal TB were exposed via the anterior approach. The pleura and peritoneum, granulation tissue, pus and dead bones of the TB, and the intervertebral disc with pathological changes and necrosis were completely eliminated...
December 10, 2015: West Indian Medical Journal
Dhanesheshwar N Lanjewar, Varsha Omprakash Bhatia, Sonali Dhaneshwar Lanjewar
BACKGROUND: Human immunodeficiency virus (HIV) infection in India has now been prevalent over three decades, and an increasing number of children are being affected with HIV. The spectrum of pathologic lesions in children with acquired immunodeficiency syndrome (AIDS) in India has not been well described. MATERIALS AND METHODS: A review of systematically conducted autopsies of 11 (10 boys and 1 girl) children with AIDS is presented. RESULTS: The mode of HIV transmission in 6 children was vertical; in one it was blood transfusion and in 4 children route was presumably vertical as these were children of orphanage...
April 2016: Indian Journal of Pathology & Microbiology
Nikhil Jain, Namita Singh Saini, Sudhir Kumar, Mukunth Rajagopalan, Kanti Lal Chakraborti, Anil Kumar Jain
INTRODUCTION: Diffusion tensor imaging (DTI) has been used in cervical trauma and spondylotic myelopathy, and it has been found to correlate with neural deficit and prognosticate neural recovery. Such a correlation has not been studied in Pott's spine with paraplegia. Hence, this prospective study has been used to find correlation of DTI parameters with neural deficit in these patients. METHODS: Thirty-four patients of spinal TB were enrolled and DTI was performed before the start of treatment and after six months...
2016: SICOT-J
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