Surgical management of craniocervical junction tuberculosis with atlanto-axial dislocation - A case report and review of the literature

Md Rezaul Amin; Md Tauhidur Rahman; A B M Manwar Hossain; Tahsina Quader; Km Tarikul Islam

doi:10.25259/SNI_731_2023

Surgical management of craniocervical junction tuberculosis with atlanto-axial dislocation - A case report and review of the literature

Surg Neurol Int. 2023 Oct 6:14:359. doi: 10.25259/SNI_731_2023. eCollection 2023.

Authors

Md Rezaul Amin¹, Md Tauhidur Rahman¹, A B M Manwar Hossain¹, Tahsina Quader¹, Km Tarikul Islam¹

Affiliation

¹ Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Abstract

Background: There are few guidelines on how to best manage craniovertebral junction (CVJ) tuberculosis (TB). Certainly, timely tissue diagnosis, immobilization of the neck, and decompression of CVJ with appropriate stabilization are the mainstays of treatment for TB at the CVJ.

Case description: Three patients, ages 16-68, presented with CVJ TB with atlanto-axial dislocation responsible for progressive quadriparesis/plegia. Based on X-rays, magnetic resonance, and computed tomography studies, patients underwent timely decompressions and fusions followed by antitubercular drug treatment.

Conclusion: Early diagnosis, proper decompression with fusion, treated with anti-TB drug for proper period were keys to managing TB involving the craniocervical junction in these three patients.

Keywords: Anti-tubercular therapy; Atlanto-axial dislocation; Craniovertebral junction; Kyphotic deformity; Tuberculosis.

Publication types

Case Reports