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. Despite modern imaging methods, tuberculous abscess in the  subdural space of the spine can lead to misdiagnosis and to neurogical  complications development, even more up to paraplegia. We presented an  extremely rare case of subdural tuberculous abscess of the lumbar (L) spine  and paraparesis in imunocompetent a 49-year-old patient. Case report. A  patient with chronic L syndrome and a history of intervertebral (IV) disc L3  and L5 operations got severe back pain late in July 2007. At the same time  the patient had a purulent collection in the left knee, and was treated with  high doses of corticosteroids and antibiotics. Then, the patient got a high  fever, the amplification of pain in the L spine and the development of  paraparesis. Erythrocyte sedimentation rate was 108 mm/1 h, Creactive protein  106.0 mg/L, white blood cell (WBC) 38.4 x 09/L with a left turn. Magnetic  resonance imaging (MRI) of the spine was registered expansive formation in  the spinal canal, from the level of the IV disc L2 to the mid-L4 vertebral  body. This finding is a “spoke” in favor of the extrusion and sequestration  of IV disc L3 with the cranial and caudal migration. The patient underwent an  emergency neurosurgical operation. The diagnosis of subdural staphylococcal  abscess of L spine was made. According to the antibiogram antibiotic therapy  was applied but without effect on the course of the disease. Control MRI of  the L spine showed spondylodiscitis L3/L4, abscess collection in the spinal  canal and paravertebral muscle abscess. Late in September 2007 the patient  underwent needle biopsy of the L3 vertebral body guided by computed  tomography and the acid-fast bacilli (AFB) were found. Tuberculostatics were  introduced in the therapy. Two years later the patient was without  significant personal difficulties, and with normal clinical, laboratory and  morphological findings. Conclusion. Subdural tuberculous abscess of the spine  is extremely rare manifestation of spine tuberculosis. The exact and early  diagnosis and adequate treatment of atypical form of spine tuberculosis are  key factors of good prognosis

Subdural tuberculous abscess of the lumbar spine in a patient with chronic low back pain