ACTA FAC MED NAISS 2012;29(4):205-211

Case report

UDC:616.71/72-002.5-089        DOI:10.2478/v10283-012-0029-z

Late Diagnosed Cervical Spine TBC Spondylitis: Case Report

Saša Milenković¹, Jordan Saveski², Ilir Hasani², Neda Trajkovska², Venko Filipče³

¹University of Niš, Faculty of Medicine, Orthopaedic& Traumatology Clinic, Niš, Serbia

²University of Skopje, Faculty of Medicine, Traumatology Clinic, Skopje, Macedonia

³University of Skopje, Faculty of Medicine, Clinic for Neurosurgery, Skopje, Macedonia


SUMMARY

Cervical tuberculosis is a rare disease with a high complication rate. Tuberculosis of the cervical spine is reported in about 6-9% of all cases of spinal tuberculosis. Early diagnosis and treatment of spinal tuberculosis is essential in order to prevent neural deficit. Management strategies for spinal tuberculosis range from ambulatory chemotherapy to radical surgical debridement with fusion. The paper presents a case of an 18-year-old patient with TBC spondylitis C3-C5. Eleven months passed from the onset of the disease until surgery and final diagnosis. When hospitalized, the patient suffered from the overall weakness, a 15-kg weight loss, dysphagia, neck pain, neck rigidity, febrility, cervical radiculopathy and paresthesia of both upper extremities. MR image showed a complete destruction of C3, abscess perforation in the anterior epidural space with the spinal cord compression and abscess extension to prevertebral space from C2 to C5. After the radical surgical debridement of C3-C5 and anterior decompression, a tricorticate autologous bone graft obtained from the iliac crest was placed and a plate fixation was done. Tuberculostatics were included for 12 months after surgery. Complete recovery occurred six months after surgery. Anterior decompression with autologous iliac bone graft led to a good clinical and radiological outcome in patients with cervical spine tuberculosis.

Key words: spine, cervical TBC spondylitis