Abstract
We report a case of tuberculous spondylitis. The patient was 52-years-old woman who had severe low back pain and right lower leg pain. The X ray film showed destructive lesion of L4 vertebral body. On the other hand, she also had stiffness on her right breast. After open biopsy of breast lesion, the histological result was breast cancer. We diagnosed the lumbar lesion as metastatic bone tumor. As CT guided needle biopsy for lumbar lesion showed no abnormal findings, the operative open biopsy followed by posterior fusion was planned. The intraoperative histology of L4 vertebral body was tuberculosis, though the metastasis of breast cancer had been expected. We underwent curettage of destructive lesion, bone grafting, and posterior fusion. Chemotherapy for tuberculosis was done postoperatively for one year. The clinical result was good, and she had no complaint after 1 year follow up. Tuberculosis must be suspected in case of destructive spondylitis.
