Mortality and morbidity rates due to the involvement of the central nervous system (CNS) tuberculosis are higher than those due to the involvement of other organ systems. Spinal tuberculosis is very rare and constitutes only 2% of CNS tuberculosis cases. A 17-year-old male patient presented with complaints of progressive loss of strength in both legs that started with numbing of the legs for three months. One-fifth loss of strength in both legs and an increase in patellar reflex were found in the motor examination. On performing unenhanced lumbar magnetic resonance imaging, the mass lesion extending from L1–L4 that was thought to be a subacute epidural hematoma was tracked. The patient was taken into operation immediately after the pre-diagnosis of subacute epidural hematoma was made. The lesion reached from the L1 vertebral corpus to the L4 corpus and had a size of 6×1 cm. Progressive improvement was seen in the paresis of the patient postoperatively. In the histopathological examination, histiocytes, lymphocytes showing caseous necrosis, and necrotizing granuloma inflammatory reaction showing granuloma structures formed by single neutrophils were observed. In line with the examination report, the patient was given a three-step anti-tuberculosis therapeutic protocol (ethambutol, rifampicin, and isoniazid) for nine months.
Corresponding Author: Ali Riza Guvercin