Spinal Tuberculosis as a Neurological Masquerader: A Clinicoradiological Case Series of Ten Patients

Dr. Rutuja Gajbhar, Dr. N. Veena, Dr. Sansmon Thomas

Abstract: Background: Spinal tuberculosis is classically recognized as tuberculous spondylodiscitis, but neurological disease may arise from vertebral, epidural, meningeal, radicular, or intramedullary involvement and may imitate inflammatory, neoplastic, or peripheral nerve disorders. Objective: To describe the clinicoradiological spectrum of spinal tuberculosis encountered in a tertiary neurology service and emphasize patterns that created diagnostic mimicry. Methods: This descriptive case series included ten patients evaluated at a tertiary care centre between July 2025 and July 2026. Clinical localization and available spinal MRI were reviewed. Cases were classified on the basis of the documented clinical context, characteristic imaging pattern, evidence of tuberculosis at spinal or extra-spinal sites when available, treatment course, and follow-up information. Results: The series encompassed classical thoracic destructive spondylitis with compressive myelopathy, early vertebral disease, vertebral collapse with instability, acute thoracic compressive myelopathy, lumbar spondylodiscitis with paraspinal abscess presenting as cauda equina syndrome, intramedullary tuberculoma, longitudinally extensive myelopathic/meningeal disease, a lesion mimicking progression of multiple myeloma, disease mimicking inflammatory spondyloarthropathy, and a painful areflexic polyradiculoneuropathy mimicking chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Conclusion: Spinal tuberculosis is anatomically and clinically heterogeneous. Recognition of the involved compartment and attention to discordant features - such as paravertebral collections in an apparent malignancy, meningeal abnormalities in longitudinal myelopathy, or severe radicular pain with active tuberculosis in a CIDP-like syndrome - can reduce diagnostic anchoring. Microbiological or histopathological confirmation should be pursued whenever feasible, particularly when the presentation is atypical.

Keywords: spinal tuberculosis, tuberculous spondylitis, myelopathy, cauda equina, intramedullary tuberculoma, arachnoiditis, polyradiculoneuropathy, CIDP mimic

How to Cite?: Dr. Rutuja Gajbhar, Dr. N. Veena, Dr. Sansmon Thomas, "Spinal Tuberculosis as a Neurological Masquerader: A Clinicoradiological Case Series of Ten Patients", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 592-598, https://www.ijsr.net/getabstract.php?paperid=SR26808210934, DOI: https://dx.doi.org/10.21275/SR26808210934

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