Case

A 20-years old female, admitted to hospital with progressive weakness of her lower limbs, no classical signs and symptoms such as night sweat, fever, weight loss, and fatigue were resent. MRI of the case showed multiple non-contiguous osteolytic lesion and bone destruction at level of vertebrae Thoracic 6-7 and Lumbar 3-4 that raised the possibility of a metastatic process. She underwent debridement treatment and posterior stabilization surgery. Pathological examination of the resected tissues revealed caseating granulomatous tuberculous lesion which confirmed the diagnosis of tuberculous spondylitis. The patient was put on a combination of anti-Tuberculous medication. Motoric improvement was achieved three monthly following the treatment, she was  able to walk without assistant .

Tuberculous spondylitis should be put into clinical suspicion in patient with skip multi-vertebral lesions who is living in area with high prevalence of TB. Through history taking and physical   examination, trials of anti-Tuberculous treatment, and routine use of MRI spine investigation also play an important role in the early diagnosis and prompt treatment.