Tuberculosis espinal: diagnóstico y manejo

Autores/as

  • Eduardo Jonathan Laos Plasier Asociación Peruana de Cirugía Vertebral. Lima, Perú. Hospital Guillermo Almenara Irigoyen – EsSalud, Departamento de Neurocirugía Servicio de Neurotrauma y Columna. Lima, Perú. Médico especialista en Neurocirugía. https://orcid.org/0000-0002-5515-2314
  • Alfonso Basurco Carpio Asociación Peruana de Cirugía Vertebral. Lima, Perú. Hospital Guillermo Almenara Irigoyen – EsSalud, Departamento de Neurocirugía Servicio de Neurotrauma y Columna. Lima, Perú. Médico especialista en Neurocirugía. https://orcid.org/0000-0002-8251-8342
  • José Luis Urquizo Rodríguez Asociación Peruana de Cirugía Vertebral. Lima, Perú. Hospital Guillermo Almenara Irigoyen – EsSalud, Departamento de Neurocirugía Servicio de Neurotrauma y Columna. Lima, Perú. Médico especialista en Neurocirugía. https://orcid.org/0000-0003-1855-5998

DOI:

https://doi.org/10.24265/horizmed.2022.v22n1.10

Palabras clave:

Enfermedades de la Columna Vertebral, Tuberculosis de la Columna Vertebral, Cifosis, Paresia

Resumen

La tuberculosis espinal representa el 50 % de los casos de tuberculosis osteoarticular y, sin un tratamiento oportuno, puede ocasionar discapacidad (por complicaciones neurológicas) y deformidad. Se sospecha de esta enfermedad con base en los antecedentes del paciente, la clínica y los hallazgos radiológicos. El diagnóstico se establece con la identificación de Mycobacterium tuberculosis, las características histopatológicas y/o hallazgo de bacilos ácido-alcohol resistentes (BAAR) en el frotis. El diagnóstico diferencial más importante de la tuberculosis espinal es la espondilodiscitis piógena. La resonancia magnética es la prueba de imagen indicada para la valoración del compromiso neurológico y el estudio diagnóstico diferencial. El tratamiento principal es la quimioterapia antituberculosa, y la cirugía puede ser coadyuvante en los casos de tuberculosis espinal complicada, luego de evaluar el déficit neurológico y la deformidad resultante. Está contraindicado realizar solamente una laminectomía, y los implantes para la artrodesis se pueden utilizar en la infección activa. El 8 % de los pacientes con déficit neurológico no logra recuperarse, aun con el tratamiento.

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Publicado

2022-03-03

Cómo citar

Laos Plasier, E. J. ., Basurco Carpio, A., & Urquizo Rodríguez, J. L. (2022). Tuberculosis espinal: diagnóstico y manejo. Horizonte Médico (Lima), 22(1), e1551. https://doi.org/10.24265/horizmed.2022.v22n1.10

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