A Case of Upper Thoracic Spinal Tuberculosis(T2-8) with T5,6 Compression Fracture in Pulmonary Tuberculosis Patient

Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.

폐결핵과 T5,6압박골절을 동반한 상부흉추(T2-8)결핵환자 1예

척추결핵은 경과가 느리고 서서히 진행하며 특이한 증상이 없으므로 임상적으로 의심하지 않으면 병이 상당히 진행된 후에야 진단되기 쉽다. 또한 침범된 부위가 척추결핵이 흔하지 않은 상부흉추, 경추, 천추부라면 진단은 더욱 늦어질 수 있다. 저자들은 국립의료원 결핵과에서 발열과 약 5개월간 지속된 상부 배부 통증으로 입원한 폐결핵환자에서 MRI 촬영으로 T5-6의 압박골절까지 초래한 상부흉추결핵을 진단하고 신경학적 이상이 생기기 전에 수술을 시행하고 항결핵약제의 치료로 좋은 결과를 얻었기에 이에 보고하는 바이다.