Seeta Dwivedi, 54 years old, female from Rewa came to Wockhardt Hospital with severe back pain. She was unable to sit, stand and walk. On investigating, she was diagnosed to have a prolapse (slip) disc in the spine.
Dr. Priyesh Dhoke, Consultant-Spine Surgery, reviewed her MRI scan. It showed features of infection in the spine mostly tuberculosis and the patient was suggested to get urgent treatment.
However, till the time patient could decide on surgery. Suddenly one day the patient lost her voice, was unable to speak, again and visited Neurologist Dr. Amit Bhatti.
He investigated her and found that her tuberculosis has reached the brain (Brain tuberculosis).
Her back pain and spine tuberculosis worsened she got a weakness in her legs and was bed-bound. The case became more complicated when the TB damaged her lungs as miliary tuberculosis of the chest. So it is a case of spinal tuberculosis with paralysis in the legs and brain and lung tuberculosis. This disseminated tuberculosis and this problem are very critical to treat.
Wockhardt’s team of doctors managed her disseminated tuberculosis and then I planned the spine surgery as 2 vertebral bones L4 & L5 were destroyed entirely and loads of pus were pressing on nerves, she is bed bound unable to sit, stand and walk with leg weakness.
Dr. Dhoke planned a spinal surgery, and had to remove the infected bony part and replace it with new bone and a big artificial metal cage to support the spine, also we have to fix the spine from lumbar to iliac fixation which is a very difficult surgery to perform. Even for anesthetists, it is a very challenging issue to manage.
The patient responded very well after successful surgery and her strength is improved, so in 3 weeks’ time, she is managing to walk confidently. We hardly see this type of extensive spread of tuberculosis in the Spine, Brain, Pelvis, and Chest all are involved with tuberculosis.
The team approach and performing the critical surgery helped the patient to recover fast and back on her feet.
Dr. Priyesh Dhoke
Wockhardt Hospitals, Nagpur
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