Treatment of Lumbar Tuberculosis with Spinal Endoscopy

Abstract

The authors present a case of a 25-year old female patient who presented to their facility with a chief complaint of low back pain and discomfort for the previous two months. The symptoms gradually worsened. The patient denied any fever, night sweats, and other aches. Symptoms worsened when standing up. They were also aggravated by changing the body position. In particular, bending forward was restricted. There was no radiating pain in the lower extremities. An MRI of the lumbar spine revealed a lesion raising suspicions of tuberculosis of the spine, which was later confirmed with biopsy and cultures. The patient was placed on oral multi anti tuberculosis antibiotic treatment but responded poorly to this treatment without much clinical improvement. Therefore, endoscopic access was chosen to debride and irrigate the paraspinal tuberculous abscess, which successfully treated the infection. The authors report the case details to illustrate that a combination of antibiotic treatment and endoscopic debridement may resolve the lumbar spine's complicated infection adequately. Minimally invasive endoscopic irrigation and lavage of paraspinal tuberculous abscesses can be considered an alternative to open surgery.