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Journal of Craniovertebral Junction and Spine
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Year : 2021  |  Volume : 12  |  Issue : 3  |  Page : 318-321

Two-stage posterior decompression and fusion for tuberculous spondylitis after intravesical bacillus Calmette-Guerin instillation

1 Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
2 Department of Neurosurgery, Bali Mandara General Hospital, Denpasar, Bali, Indonesia
3 Department of Neurosurgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
4 Department of Neurosurgery, Moriguchi-Ikuno Memorial Hospital, Osaka, Japan

Correspondence Address:
Hiroki Ohata
Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcvjs.jcvjs_201_20

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Intravesical bacillus Calmette-Guerin (BCG) instillation is an effective treatment for nonmuscle invasive superficial bladder cancer. BCG induces a massive influx of inflammatory cells and production of cytokines in the bladder mucosa and lumen that leads to an immune response against tumor cells, acting as an immunotherapy. Cystitis, bladder ulceration, and bladder contracture are known local genitourinary complications, whereas systemic complications such as miliary pulmonary tuberculosis, mycotic aneurysms, tuberculous spondylodiscitis, and granulomatous hepatitis are very rare. A case of tuberculous spondylodiscitis at the T8 and T9 levels following intravesical BCG instillation for bladder carcinoma is reported. The patient initially underwent decompressive laminectomy for spastic paraparesis. After reporting improvement for few weeks, the patient again presented with similar complaints and was found to have an increased kyphotic deformity, for which he underwent fixation surgery.

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