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Rehabilitation Practice and Science

Translated Title

脊髓內結核瘤引起之雙下肢無力：病例報告

Abstract

Tuberculosis is one of the oldest diseases known to affect humans and is a major cause of death worldwide. This disease, which is caused by bacteria of the Mycobacterium tuberculosis complex, usually affects the lungs, although other organs are involved in up to one-third of cases. If properly treated, tuberculosis caused by drug-susceptible strains is curable in virtually all cases. Spinal tuberculosis (Pott's disease or tuberculous spondylitis) often involves two or more adjacent vertebral bodies, and solitary tuberculoma of the spinal cord as part of a generalized infection is a rarity. Here, we report the case of a 54-year-old man who suffered sudden bilateral lower-limb weakness. Incidentally, open pulmonary tuberculosis was diagnosed by sputum smear examination and typical chest X-ray findings. The patient was placed under isolation and anti-tuberculosis medication was administered immediately, upon which the lower-limb weakness appeared initially improved. However, deterioration in muscle strength occurred one month later, and magnetic resonance imaging (MRI) revealed an intramedullary tumor of the spinal cord at the T7 level. A laminectomy with excision of the tumor was performed, and the subsequent pathological findings were compatible with tuberculoma. Following surgery, the patient underwent a complete course of anti-tuberculosis medication and an intensive rehabilitation program. He exhibited excellent functional recovery and achieved independence in activities of daily living. There was no evidence of recurrence after 6 months of follow-up. The outcome of this case indicates that immediate diagnosis, proper surgical intervention and medication in combination with an intensive rehabilitation program were all crucial to the successful treatment of this rare disease.

Language

Traditional Chinese

First Page

45

Last Page

51

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