title: Spinal tuberculosis of the lumbar spine after percutaneous vertebral augmentation (vertebroplasty or kyphoplasty).
abstract: BACKGROUND
  Spinal tuberculosis occurring after percutaneous vertebral augmentation has rarely been described. To date, only two such cases have been documented in the literature. Vertebral augmentation may reactivate a quiescent tuberculous lesion and promote the infective process in elderly patients with or without immunosuppression, thereby resulting in poor outcomes.
  
  
  OBJECTIVE
  The purposes of this study were to present two cases in which spinal tuberculosis occurred after vertebroplasty or kyphoplasty, to highlight the clinical features and need for early diagnosis of this pathology, and to postulate probable reasons for this association.
  
  
  METHODS
  This study is based on a clinical case series and literature review.
  
  
  METHODS
  In this report, we review the clinical histories of two old women undergoing vertebral augmentation with subsequent spinal tuberculosis.
  
  
  RESULTS
  The first patient responded favorably to conservative treatment with multidrug antitubercular therapy and spinal braces. The second patient underwent surgical debridement through a posterior approach alone, without instrumentation, combined with adjuvant chemotherapy. By 1 year after treatment, both patients had experienced almost complete recovery and continued to be seen for follow-up visits.
  
  
  CONCLUSIONS
  Suspicion should be high, and magnetic resonance imaging is warranted in cases with deteriorating clinical symptoms and signs of acute infection after vertebral augmentation. We propose obtaining exhaustive microbiologic and histologic evidence via needle biopsy or open surgery in a timely fashion to establish an accurate diagnosis because tubercular spondylitis occurring in such a situation may progress rapidly.
authors.affiliation: Department of Spine Surgery, The Second Xiangya Hospital of Central South University, No. 139, Middle of Renmin Rd, Changsha, Hunan 410011, People's Republic of China.
authors.forename: Ming-Xiang
authors.initials: MX
authors.lastname: Zou
authors.affiliation: Department of Spine Surgery, The Second Xiangya Hospital of Central South University, No. 139, Middle of Renmin Rd, Changsha, Hunan 410011, People's Republic of China.
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Wang
authors.affiliation: Department of Spine Surgery, The Second Xiangya Hospital of Central South University, No. 139, Middle of Renmin Rd, Changsha, Hunan 410011, People's Republic of China. Electronic address: jingli1969@126.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Spine Surgery, The Second Xiangya Hospital of Central South University, No. 139, Middle of Renmin Rd, Changsha, Hunan 410011, People's Republic of China.
authors.forename: Guo-Hua
authors.initials: GH
authors.lastname: Lv
authors.affiliation: Department of Spine Surgery, The Second Xiangya Hospital of Central South University, No. 139, Middle of Renmin Rd, Changsha, Hunan 410011, People's Republic of China.
authors.forename: You-Wen
authors.initials: YW
authors.lastname: Deng
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D016103:Spinal Fractures / Q000601:surgery*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D054854:Vertebroplasty / Q000009:adverse effects*
chemical_list: D000995:Antitubercular Agents
keywords: Lumbar spine; Mycobacterium tuberculosis; Percutaneous kyphoplasty; Percutaneous vertebroplasty; Spinal tuberculosis; Vertebral augmentation