Subjacent Disease in an Operated Case of Spinal Tuberculosis: A Case Report and Literature Review

INTRODUCTION: Spinal tuberculosis (TB) recurrence in subjacent vertebral segments in a post-operative case is one of the atypical presentations of this common disease. CASE REPORT: A 63-year-old gentleman presented with fever and bilateral lower limb weakness for 10 days. The patient was on anti-tubercular therapy for the past 18 months and had a history of surgical decompression and posterior instrumentation for D12 and L1 vertebrae spinal TB. Radiological investigations showed new-onset TB in D9 and D10 vertebral levels. Management with revision surgery was done. CONCLUSION: Recurrence of spinal TB in segments of vertebrae subjacent to previously operated segments in a patient on long-term anti-tubercular treatment is a rare and undescribed presentation of the common disease. High index of suspicion is required for early diagnosis and prompt management to prevent long-term morbidities.