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Case Report

Tuberculous Spondylitis of Craniovertebral Junction of a 70 Years Old Female: Case Report and Review of the Literature

Craniovertebral junction tuberculosis is rare, accounting for 0.3 to 1% of all tuberculous spondylitis cases. MR imaging is the modality of choice to detect bone involvement, abscess formation, pre and paravertebral collection, sub ligamentous spreading o , Shahidul Islam Khan1 , Kamrul Ahsan2 , Nazmin Ahmed3 , Bipin Chaurasia4 , Dhiman Chowdhury5

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International Journal of Neurology and Neurosurgery 10(3):p 269-272, Jul-Sep 2018. | DOI: DOI: http://dx.doi.org/10.21088/i6nns.0975.0223.10318.20

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Abstract

Craniovertebral junction tuberculosis is rare, accounting for 0.3 to 1% of all tuberculous spondylitis cases. MR imaging is the modality of choice to detect bone involvement, abscess formation, pre and paravertebral collection, sub ligamentous spreading of the pus and to differentiate from other lesions affecting the craniovertebral junction. It is also helpful to determine the modality of treatment and monitor the efficacy of treatment. Surgical treatment of patients with craniovertebral junction tuberculosis has been associated with highmortality rate ranging up to 10% and recurrence rate ranging up to 20%, conservative treatment is the modality of choice for most of the cases. We present a case of craniovertebral junction Mycobacterium tuberculosis infection diagnosed with clinical, serological and radiological evidence. A Philadelphia collar was applied for external immobilization and anti­tuberculous treatment with rifampicin, isoniazid, pyrazinamide and ethambutol was initiated. After completion of the initiation phase, the patient wasneurologically improved. MRI showed marked resolution of the craniovertebral mass. Antituberculous treatment was advised to continue for next 15 months. 

Keywords: Tuberculous Spondylitis; Craniovertebral Junction; Anti­TB Therapy.

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DOI: DOI: http://dx.doi.org/10.21088/i6nns.0975.0223.10318.20

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