Tuberculous osteomyelitis of the lumbosacral region: a spinal epidural abscess with presacral extension

Abstract

Introduction: Tuberculous osteomyelitis in the lumbosacral region is an uncommon occurrence, and its treatment is not well-defined in the literature, particularly when it is associated with abscess formation. We present the outcome of a patient who had an epidural abscess with presacral extension.

Materials and methods: A 30-year-old man had microbiologically confirmed tuberculous infection of the lumbosacral vertebrae complicated by extensive abscess formation. After a trial of chemotherapy, the infection proved refractory, and the treatment proceeded with abscess drainage through the anterior route.

Results: Approximately 1 year after surgery, the patient was symptom-free and did not show any significant radiologic changes.

Conclusion: Antituberculous chemotherapy combined with anterior surgery seems to be beneficial in the setting of lumbosacral osteomyelitis complicated by epidural abscess formation with presacral extension.