One-stage anterior approach for long-segment subaxial cervical spondylitis tuberculosis: A case report

Int J Surg Case Rep. 2022 Oct:99:107693. doi: 10.1016/j.ijscr.2022.107693. Epub 2022 Sep 21.

Abstract

Background: Spondylitis TB on cervical region is a rare disease, that may lead to severe neurological complications. The anterior approach is considered as a gold standard for cervical spine tuberculosis. Available studies and literature have not precisely mentioned on how many levels are acceptable for this disease and still up for discussion.

Case presentation: A 45-year-old Asian male was brought from a rural hospital to our outpatient clinic with progressive weakness of all extremities for 3 months. Cervical x-ray and MRI showed three-levels of vertebral body destruction, suggesting a cervical spondylitis TB. Patient had debridement, corpectomy on C4, 5, 6, fusion with cage, and anterior plating from C3 to Th1 in a one-stage anterior approach. Immediately after the surgery, the patient had no complaints of pain, and he was able to walk on his own. One year follow-up after the surgery, no residual neurological impairment is detected and had no limitation in daily activities. Cervical x-ray and MRI showed good ossification and improvement of lordotic curvature.

Conclusion: Treatment of cervical spondylitis TB which involved three-levels of vertebrae using one-stage anterior approach provides a good rate of deformity correction along with clinical improvement and long-term well-being of the patient.

Keywords: Anterior approach; Cervical spondylitis; Extrapulmonary TB; Surgery; Tuberculosis.

Publication types

  • Case Reports