Abstract
Background. Tuberculosis is a systemic disease most often affecting the respiratory system. However, 1-3% of patients present with lesions of the osseous system, usually in the spinal column. Tuberculous lesions are located in the anterior part of two adjacent vertebral bodies with the intervertebral disk. The initial symptoms are nonspecific. The patients' complaints include osseous pain, limited mobility and local tenderness, weight loss, hyperhidrosis and subfebrile body temperature. Classic X-ray examination and imaging techniques, including computed tomography (CT) and magnetic resonance imaging (MRI), are most useful in the diagnostic procedure. Antituberculotic therapy should be implemented immediately on diagnosing the condition, and the treatment period of 9-12 months is recommended.
Case reports. The authors present two patients with back pain, diagnosed with spinal tuberculosis at the neurology department on the grounds of their medical history, neurological examination, and imaging techniques. Specific antituberculotic therapy supplemented with multidirectional treatment was rapidly implemented and continued over many months. The treatment was effective – the symptoms disappeared, and the patients' motor ability improved attaining the premorbid level.
Commentary. In patients with inexplicable back pains a possibility of skeletal tuberculosis should be taken into account, especially if systemic symptoms are present. The use of imaging techniques is most important in the diagnostic procedure. Early diagnosis and proper treatment of vertebral tuberculosis can lead to full recovery. Interdisciplinary cooperation among different medical specialists as in the reported cases, seems crucial in the process of diagnosis and comprehensive treatment.