Tuberculous spondylitis following percutaneous vertebral augmentation: 3 case reports and literature review
Chen Wei, Liu Boling, Xue Jinglai, Liang Guiqing, Wang Huafeng
Department of Spine Surgery, Fuzhou Second Hospital Affiliated to Xiamen University, the Third Clinical Medical College, Fujian Medical University, Fuzhou 350007, China
Abstract：Objective To present three cases of tuberculous spondylitis following percutaneous vertebral augmentation and to investigate the pathogenesis, clinical characteristics, and treatment by reviewing the literatures. Methods The literatures about tuberculous spondylitis following percutaneous vertebral augmentation before December 2020 were searched in China National Knowledge Infrastructure, Weipu, Wanfang, and PubMed database using "percutaneous vertebral augmentation," "percutaneous vertebroplasty," "percutaneous kyphoplasty," and "tuberculous spondylitis" as key words. Eight English studies on nine cases of tuberculous spondylitis following percutaneous vertebral augmentation were included. The pathogenesis, clinical characteristics, and treatment were summarized and analyzed. Results Two cases were cured by surgery combined with antituberculosis medications at 12-month follow-up. One patient died of pulmonary infection during the treatment. Twelve cases of tuberculous spondylitis following percutaneous vertebral augmentation were involved, including three cases in the present study and nine reported cases. Three males and nine females, aged 54 to 83 years old, were included. All 12 cases were readmitted because of recurrent severe pain symptoms postoperatively, and the erythrocyte sedimentation rate and C-reactive protein were high. Imaging examinations showed bone resorption around bone cement, narrowing of intervertebral space, and vertebral edema signal. Two patients died of perioperative complications. After surgery, the other 10 patients continued antituberculosis treatments for 10-18 months and recovered completely without sequelae. Conclusions Although the incidence of tuberculous spondylitis following percutaneous vertebral augmentation is rare, suspicion should be high in cases with deteriorating clinical symptoms after vertebral augmentation. The mechanism of tuberculous spondylitis following percutaneous vertebral augmentation remains controversial. Early surgical intervention and antituberculosis medications should be instituted as soon as the diagnosis of tuberculous spondylitis following percutaneous vertebral augmentation is made.
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Chen Wei, Liu Boling, Xue Jinglai, Liang Guiqing, Wang Huafeng. Tuberculous spondylitis following percutaneous vertebral augmentation: 3 case reports and literature review. Chinese Journal of Anatomy and Clinics, 2022, 27(1): 35-41.
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2022, Vol. 27 
