Isolated sacral tuberculosis: A case report and systematic literature review

Background: Tuberculosis remains a rampant infectious disease affecting developing countries. Isolated sacral tuberculosis is extremely rare. The aim of this work was to highlight the epidemiological, clinical, radiological features and outcomes of this rare site of spinal tuberculosis. Methods: We report a case of a 62-year-old-man patient that presented an isolated sacral tuberculosis. We conducted research on PubMed and Scopus databases from 1974 to March 2023 using the following search terms /“isolated AND sacral AND tuberculosis/”. Results: We retrieved 7 case reports and 1 case series published. A total of 10 patients were identified. The mean age was 37.6 ± 15.4 years (range 20–72). There were 3 males and 7 females. The most common symptoms were sciatica (70%). Neurological examination revealed monoparesis (10%), paraparesis (20%) and no motor deficit (70%). The radiological characteristics of mass lesion, on magnetic resonance imaging, were low intensity in T1-weighted imaging and high intensity in T2-weighted imaging (80%), with paravertebral abscess (90%). The procedures of diagnosis mostly used were needle aspiration (80%). All patients saw clinical improvement (100%). Conclusion: The sacrum spinal is a rare the site of spinal tuberculosis. We believe that gadolinium enhanced MR imaging fat saturation is particularly valuable for diagnosis. The prognosis is good under antibacillary chemotherapy