Progressive Thoracolumbar Tuberculosis in a Young Male: Diagnostic, Therapeutic, and Surgical Insights

Objective: We present the case of a 26-year-old male with severe spinal tuberculosis of the thoracolumbar region. The patient suffered from worsening back pain over five years, initially responding to over-the-counter analgesics. Despite being proposed surgery in 2019, the patient refused the interv...

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Main Authors: Dana-Georgiana Nedelea (Author), Diana Elena Vulpe (Author), George Viscopoleanu (Author), Alexandru Constantin Radulescu (Author), Alexandra Ana Mihailescu (Author), Sebastian Gradinaru (Author), Mihnea Orghidan (Author), Cristian Scheau (Author), Romica Cergan (Author), Serban Dragosloveanu (Author)
Format: Book
Published: MDPI AG, 2024-10-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Dana-Georgiana Nedelea  |e author 
700 1 0 |a Diana Elena Vulpe  |e author 
700 1 0 |a George Viscopoleanu  |e author 
700 1 0 |a Alexandru Constantin Radulescu  |e author 
700 1 0 |a Alexandra Ana Mihailescu  |e author 
700 1 0 |a Sebastian Gradinaru  |e author 
700 1 0 |a Mihnea Orghidan  |e author 
700 1 0 |a Cristian Scheau  |e author 
700 1 0 |a Romica Cergan  |e author 
700 1 0 |a Serban Dragosloveanu  |e author 
245 0 0 |a Progressive Thoracolumbar Tuberculosis in a Young Male: Diagnostic, Therapeutic, and Surgical Insights 
260 |b MDPI AG,   |c 2024-10-01T00:00:00Z. 
500 |a 10.3390/idr16050080 
500 |a 2036-7449 
520 |a Objective: We present the case of a 26-year-old male with severe spinal tuberculosis of the thoracolumbar region. The patient suffered from worsening back pain over five years, initially responding to over-the-counter analgesics. Despite being proposed surgery in 2019, the patient refused the intervention and subsequently experienced significant disease progression. Methods: Upon re-presentation in 2022, mild involvement of the T12-L1 vertebrae was recorded by imaging, leading to a percutaneous needle biopsy which confirmed tuberculosis. Despite undergoing anti-tuberculous therapy for one year, the follow-up in 2024 revealed extensive infection from T10 to S1, with large psoas abscesses and a pseudo-tumoral mass of the right thigh. The patient was ultimately submitted to a two-stage surgical intervention: anterior resection and reconstruction of T11-L1 with an expandable cage, followed by posterior stabilization from T8-S1. Results: Postoperative recovery was uneventful, with significant pain relief and no neurological deficits. The patient was discharged on a continued anti-tuberculous regimen and remains under close surveillance. Conclusions: This paper presents details on the challenges of diagnosis and management of severe spinal tuberculosis, with emphasis on the importance of timely intervention and multidisciplinary care. 
546 |a EN 
690 |a spinal tuberculosis 
690 |a tuberculous spondylitis 
690 |a surgical management 
690 |a medical imaging 
690 |a expandable cage reconstruction 
690 |a multidisciplinary approach 
690 |a Other systems of medicine 
690 |a RZ201-999 
655 7 |a article  |2 local 
786 0 |n Infectious Disease Reports, Vol 16, Iss 5, Pp 1005-1016 (2024) 
787 0 |n https://www.mdpi.com/2036-7449/16/5/80 
787 0 |n https://doaj.org/toc/2036-7449 
856 4 1 |u https://doaj.org/article/c2453d2355df4f62bd6573f6413c07f0  |z Connect to this object online.