# Sternal Puncture-Induced Acute Spinal Cord Syndrome in a Myeloma-Remissive Patient Revealing Pott Disease: A Case Report

## TL;DR

A patient with a history of multiple myeloma developed acute spinal cord syndrome after a sternal puncture, revealing Pott disease and leading to successful anti-tuberculosis treatment.

## Contribution

This case report highlights an unusual complication of sternal puncture and the successful treatment of Pott disease in a myeloma patient.

## Key findings

- Acute paraplegia occurred in a patient during sternal puncture, revealing spinal cord compression from an abscess.
- Pott disease was diagnosed based on clinical and imaging findings, and anti-tuberculosis treatment led to significant recovery.
- Decompressive surgery was not performed due to the patient's fragile health, but radiotherapy was deemed unnecessary due to myeloma remission.

## Abstract

Cord compression is not a known complication of sternal puncture. We report the case of a patient with a history of multiple myeloma who presented acute onset paraplegia brought on during sternal puncture. Neuroimaging revealed focal spondylodiscitis and cord compression by an abscess. Neurosurgical decompression was not carried out on the patient because of her fragile general state of health and tardy consultation. Workup revealed the patient in remission from her multiple myeloma thus making decompressive radiotherapy unnecessary. The diagnosis of Pott disease was made by taking into account the clinical presentation, spine imaging and extra neurological imaging findings. Empiric anti-tuberculosis treatment was initiated which resulted in spectacular outcomes with a patient being able to walk with little aid by the end of her nine-month treatment course.