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ORIGINAL ARTICLE
Year : 2003  |  Volume : 37  |  Issue : 3  |  Page : 12

Intraspinal tubercular granuloma - An analysis of 17 cases


Department of Orthopedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India

Correspondence Address:
A K Jain
Deptt. Of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi-110095
India
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Source of Support: None, Conflict of Interest: None


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Seventeen cases of intraspinal tubercular granuloma (15 extradural, 2 intramedullary) with neurological deficit are reported. Only three cases had past history of tuberculosis. Vertebral involvement could be appreciated on plain X-rays only in 3 cases, while it could be established in another 7 out of 11 cases in which CT/ MRI was undertaken. Myelogram showed a block in 8 cases. Laminectomy and surgical decompression was done in 16 cases (15 extradural, 1 intramedullary), while 1 case of intra-medullary granuloma resolved on anti-tubercular therapy and bed rest. The histopathological examination in all the 16 cases confirmed tuberculosis. Ten out of 15 cases of extradural granuloma recovered neurologically while 5 did not improve. One case of intramedullary granuloma died 2 months after surgery while the other recovered neurologically within 6 months of bed rest and anti-tubercular therapy. The potential for excellent recovery with adequate treatment, compared with considerably increased chances of failure of neural recovery and increased morbidity following a missed diagnosis, is the stimulus for increasing awareness of the condition.


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