Compression médullaire au cours d’une spondylodiscite tuberculeuse: à propos d’un cas

We here report the case of a 76-year old patient admitted to Pulmonology Department with tuberculous spondylodiscitis diagnosed on the basis of clinical signs including weight loss, prolonged fever and stabbing lumbar pain occurred 2 months before. The diagnosis was confirmed by lumbar CT scan and by Genexpert TB test on lumbar fluid taken from the abnormal L1 vertebral body, which showed mycobacterium tuberculosis. Three weeks after the beginning of treatment the patient had motor deficit in lower limbs followed by sensory deficit. These abnormalities were confirmed by MRI which showed abnormal L1 somatic signal with collapse of the vertebral body (A). These lesions enhanced after gadolinium injection (B) that also showed posterior cortical rupture with epiduritis. Radiological examination was performed which confirmed the diagnosis of spinal cord compression associated with TB spondylodiscitis. A few days after, the patient had severe sepsis complicated by septic shock after which he died. Spinal compression is rare in patients with spondylodiscitis. It has a high potential for irreversible complications in the absence of early treatment for spinal cord decompression. Surgery and early antibacillar treatment ensure favorable outcome in the medium and long term.