Ligamentum flavum hypertrophy in a patient with Pott’s disease
Introduction. The spine is involved in less than 1% of all tuberculosis (TB) cases, and it is a very dangerous type of skeletal TB as it can be associated with neurologic deficit and even paraplegia due to compression of adjacent neural structures and significant spinal deformity. The spine TB is on...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Serbian Medical Society
2020-01-01
|
| Series: | Srpski Arhiv za Celokupno Lekarstvo |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81792000077A.pdf |
| _version_ | 1818610373035556864 |
|---|---|
| author | Aleksić Vuk Ilić Rosanda Milićević Mihailo Milisavljević Filip Joković Miloš |
| author_facet | Aleksić Vuk Ilić Rosanda Milićević Mihailo Milisavljević Filip Joković Miloš |
| author_sort | Aleksić Vuk |
| collection | DOAJ |
| description | Introduction. The spine is involved in less than 1% of all tuberculosis (TB) cases, and it is a very dangerous type of skeletal TB as it can be associated with neurologic deficit and even paraplegia due to compression of adjacent neural structures and significant spinal deformity. The spine TB is one of the most common causes for an angular kyphotic deformity of spine. Patients with kyphosis angle ≥ 60° at dorsolumbar spine are at great risk to develop late onset neurological deficit and paraplegia due to chronic compression and stretching of the spinal cord over bonny ridges. In a small number of cases, other conditions may lead to neurological deficit in patients with long standing angular kyphosis which also alters the treatment strategy that otherwise involves prolonged and mutilant surgery. Case outline. We present a case of a 61-year-old male patient with concomitant 90° dorsolumbar spine kyphosis due to spinal TB and ligamentum flavum hypertrophy which led to spinal canal stenosis with myelopathy, and consequent paraplegia. The patient underwent dorsal decompression with hypertrophic yellow ligament removal after which he recovered to the level of walking. Conclusion. Many authors propose guidelines for treatment of spinal TB, taking into account the stage of the disease, the age of the patient, the angle of kyphosis, and other factors. We find that personalized medical approach is the best approach for each patient. |
| first_indexed | 2024-12-16T15:13:24Z |
| format | Article |
| id | doaj.art-9c950c84ebab4725a54f1446059c56c8 |
| institution | Directory Open Access Journal |
| issn | 0370-8179 2406-0895 |
| language | English |
| last_indexed | 2024-12-16T15:13:24Z |
| publishDate | 2020-01-01 |
| publisher | Serbian Medical Society |
| record_format | Article |
| series | Srpski Arhiv za Celokupno Lekarstvo |
| spelling | doaj.art-9c950c84ebab4725a54f1446059c56c82022-12-21T22:26:54ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792406-08952020-01-0114811-1275776010.2298/SARH191201077A0370-81792000077ALigamentum flavum hypertrophy in a patient with Pott’s diseaseAleksić Vuk0Ilić Rosanda1Milićević Mihailo2Milisavljević Filip3Joković Miloš4University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, Serbia + Clinical Hospital Center Zemun, Department of Neurosurgery, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, SerbiaIntroduction. The spine is involved in less than 1% of all tuberculosis (TB) cases, and it is a very dangerous type of skeletal TB as it can be associated with neurologic deficit and even paraplegia due to compression of adjacent neural structures and significant spinal deformity. The spine TB is one of the most common causes for an angular kyphotic deformity of spine. Patients with kyphosis angle ≥ 60° at dorsolumbar spine are at great risk to develop late onset neurological deficit and paraplegia due to chronic compression and stretching of the spinal cord over bonny ridges. In a small number of cases, other conditions may lead to neurological deficit in patients with long standing angular kyphosis which also alters the treatment strategy that otherwise involves prolonged and mutilant surgery. Case outline. We present a case of a 61-year-old male patient with concomitant 90° dorsolumbar spine kyphosis due to spinal TB and ligamentum flavum hypertrophy which led to spinal canal stenosis with myelopathy, and consequent paraplegia. The patient underwent dorsal decompression with hypertrophic yellow ligament removal after which he recovered to the level of walking. Conclusion. Many authors propose guidelines for treatment of spinal TB, taking into account the stage of the disease, the age of the patient, the angle of kyphosis, and other factors. We find that personalized medical approach is the best approach for each patient.http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81792000077A.pdfkyphotic deformitylate onset paraplegiatb spinespinal canals stenosisflavum hypertrophy |
| spellingShingle | Aleksić Vuk Ilić Rosanda Milićević Mihailo Milisavljević Filip Joković Miloš Ligamentum flavum hypertrophy in a patient with Pott’s disease Srpski Arhiv za Celokupno Lekarstvo kyphotic deformity late onset paraplegia tb spine spinal canals stenosis flavum hypertrophy |
| title | Ligamentum flavum hypertrophy in a patient with Pott’s disease |
| title_full | Ligamentum flavum hypertrophy in a patient with Pott’s disease |
| title_fullStr | Ligamentum flavum hypertrophy in a patient with Pott’s disease |
| title_full_unstemmed | Ligamentum flavum hypertrophy in a patient with Pott’s disease |
| title_short | Ligamentum flavum hypertrophy in a patient with Pott’s disease |
| title_sort | ligamentum flavum hypertrophy in a patient with pott s disease |
| topic | kyphotic deformity late onset paraplegia tb spine spinal canals stenosis flavum hypertrophy |
| url | http://www.doiserbia.nb.rs/img/doi/0370-8179/2020/0370-81792000077A.pdf |
| work_keys_str_mv | AT aleksicvuk ligamentumflavumhypertrophyinapatientwithpottsdisease AT ilicrosanda ligamentumflavumhypertrophyinapatientwithpottsdisease AT milicevicmihailo ligamentumflavumhypertrophyinapatientwithpottsdisease AT milisavljevicfilip ligamentumflavumhypertrophyinapatientwithpottsdisease AT jokovicmilos ligamentumflavumhypertrophyinapatientwithpottsdisease |