J Korean Neurosurg Soc.  2007 Nov;42(5):406-409. 10.3340/jkns.2007.42.5.406.

Craniovertebral Junction Tuberculosis with Atlantoaxial Dislocation: A Case Report and Review of the Literature

• Lee DK
• Cho KT
• Im SH
• Hong SK

• KMID: 1956219
• DOI: http://doi.org/10.3340/jkns.2007.42.5.406

Abstract

Craniovertebral junction (CVJ) tuberculosis is a rare disease, potentially causing severe instability and neurological deficits. The authors present a case of CVJ tuberculosis with atlantoaxial dislocation and retropharyngeal abscess in a 28-year-old man with neck pain and quadriparesis. Radiological evaluations showed a widespread extradural lesion around the clivus, C1, and C2. Two stage operations with transoral decompression and posterior occipitocervical fusion were performed. The pathological findings confirmed the diagnosis of tuberculosis. Treatment options in CVJ tuberculosis are controversial without well-defined guidelines. But radical operation (anterior decompression and posterior fusion and fixation) is necessary in patient with neurological deficit due to cord compression, extensive bone destruction, and instability or dislocation. The diagnosis and treatment options are discussed.

Keyword

Tuberculosis; Craniovertebral junction; Atlantoaxial dislocation; Retropharyngeal abscess

MeSH Terms

Adult
Cranial Fossa, Posterior
Decompression
Diagnosis
Dislocations*
Humans
Neck Pain
Quadriplegia
Rare Diseases
Retropharyngeal Abscess
Tuberculosis*