Non-contiguous multifocal spinal tuberculosis involving cervical, thoracic, lumbar and sacral segments:: a case report

Main problem: There are only a few cases reported with non-contiguous spinal tuberculosis in the literature. Most of these patients have only two non-contiguous lesions, and in almost all of these cases, surgical treatment is required. Methods: A 17-year-old girl with non-contiguous multifocal spinal tuberculosis involving cervical, thoracic, thoracolumbar, lumbar and sacral segments is reported. The patient presented with systemic tuberculosis symptoms and signs, and progressive paraparesis. Results: The patient was treated with antituberculous drug therapy and was operated twice for thoracolumbar and cervical spinal lesions. She made an excellent neurological recovery. Conclusions: In the patients with non-contiguous spinal involvement, there is a high percentage of requirement of surgical treatment. This may be due to "fulminant" behaviour of the disease in these patients. Early surgical treatment of the cases with large abscesses and systemic tuberculosis may provide early improvement, and must probably be the first treatment modality after general support to the patient.