History :
A 34-year-old man came to Best Spine Hospital in Pune Dr. Sangram Rajale with complaints of low back pain for 5 years, along with right lower limb radiculopathy. His pain was constant, worsening with movement and log rolling. For the last 5 years, both the patient and his wife were extremely troubled as they could not find a diagnosis. About a year ago, the patient had to quit his job and stayed at home, and in the last 6 months, he was completely bedridden. Even basic tasks like going to the washroom became difficult, and he became fully dependent on his wife and parents for all his daily activities.
The patient needed support to get up. He had a history of evening fever, weight loss, loss of appetite, and night sweats. Getting out of bed in the morning was very challenging for him.
On Examination (O/E):
- His gait was severely painful, with the pain most significant in his lower back.
- Flexion and extension of the lumbar spine were extremely painful and nearly impossible.
Radiological Investigations :
X-ray of Spine:
Showed a destructive lesion at L1-L2.
MRI Lumbosacral Spine:
Showed osteitis and discitis at the L1-L2 level, with abscess formation and collapse of the vertebrae. Canal stenosis was noted, suggestive of Potts spine (spinal tuberculosis).
Operation :
On November 21, 2022, Dr. Sangram Rajale, the Best Spine Surgeon in Pune, performed posterolateral fusion and debridement from D11 to L4 under general anesthesia. The surgery was successful, and samples sent for microbiology confirmed spinal tuberculosis. JAYON implants were used during the procedure.
Histopathology (L1-L2 Disc and Body)
- Indicated granulomatous inflammation, most likely tuberculosis.
Gene Xpert MTB/RIF with AFB Culture
-
Mycobacterium Tuberculosis Complex (MTB) detected at a low level.
Condition On Discharge :
After surgery, the patient was diagnosed with spinal tuberculosis, which was treated with fixation, fusion, and debridement. He was started on long-term anti-tubercular treatment (AKT) for one year. When he returned for follow-up after a year, he expressed deep gratitude for the successful surgery by Dr. Sangram Rajale, known as the Best Spine Specialist in Pune. Today, the patient is pain-free, can lift weights up to 30-40 kg without any difficulty, and has returned to work. He is no longer dependent on others for basic needs like going to the washroom or maintaining personal hygiene, all thanks to the expert care provided by Top Spine Specialist in Pune Dr. Sangram Rajale.