Spinal intramedullary tuberculosis: a series of 15 cases.
OBJECTIVE
Spinal intramedullary tuberculosis is a rare disease. This study aims to acquaint readers with its clinicoradiological features and emphasizes the importance of early treatment in intramedullary spinal tuberculosis.


METHODS
Retrospective analysis was conducted from 1985 to 2006 over a period of 21 years and data were retrieved from patient records at our institute (single centre study). Clinicoradiological and pathological data were reviewed along with final outcome at discharge and analyzed.


RESULTS
Fifteen patients were analyzed. Mean age of presentation was 31 years (range: 18-45 years), with average duration at presentation being 11 months (2-24 months). Common locations: dorsal region: 7 cases, cervical: 5 cases, cervicodorsal: 2 cases and dorsolumbar region: 1 case. Sensori-motor involvement was noted in fourteen patients. Bowel and bladder involvement was seen in ten patients while one patient had respiratory distress. Only 40% of patients had secondary involvement of spine while the rest of the cases were having primary spinal intramedullary tuberculosis. Three patients had previous history of tubercular meningitis, while one patient had old pulmonary tuberculosis. There were one case each of cervical node involvement and intracranial granuloma. Twelve patients underwent surgery while others were conservatively managed, all patients received antitubercular therapy for 18 months. Nine of the twelve operated patients showed improvement in motor power, while two of the conservatively managed patients improved. Patients presenting late had a poorer outcome.


CONCLUSIONS
Spinal intramedullary tuberculosis is a non-malignant, treatable lesion giving a good outcome on management. Surgically managed patients showed a better outcome.
Ramdurg
Shashank R
SR
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Gupta
Deepak Kumar
DK
Suri
Ashish
A
Sharma
Bhavani Shankar
BS
Mahapatra
Ashok Kumar
AK
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology; D013118:Spinal Cord Diseases / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014375:Tuberculoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology; D055815:Young Adult