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Cervical Tuberculosis Associated with Cervical Pain and Neurological Deficit: a Case Report and Literature Review.
MedLine Citation:
PMID:  24262857     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND CONTEXT: Isolated tuberculosis (TB) of posterior elements of the cervical spine is extremely rare. Only few cases are reported in literature but none described isolated spinous process and laminae involvement without TB in any other part of the body.
PURPOSE: The authors report a case of isolated TB involvement of the spinous process and right laminae of C2 combined with atlantoaxial luxation.
STUDY DESIGN: A case report of isolated spinous process and right laminae TB of C2 combined with atlantoaxial luxation.
PATIENT SAMPLE: a 20-year-old male peasant complained about a 2-month history of aggravating neck pain, of a 1-month history of a slowly growing lump at the back of neck, and of numbness and weakness of the right arm, which had gradually progressed to involve all the limbs for 2 weeks before presentation.
OUTCOME MEASURES: X-ray and CT of cervical spine and Frankel grading of neural function are included to evaluate the therapeutic efficiency.
METHODS: CT scans showed flake-like bony destruction located in the spinous process and at right laminae of C2. MRI showed a large swelling lump posterior to C2 and atlantoaxial luxation induced distinct compression of the spinal cord. The patient underwent 2-weeks of skull traction and quadruple anti-TB treatment before surgery.
RESULTS: The patient underwent surgical treatment which included posterior radical debridement, decompression, internal fixation with a screw-rod system from C1 to C4, autologous bone grafting and fusion. The patient gained normal neural function and returned to work one year after surgery.
CONCLUSIONS: TB of the posterior elements of the upper cervical spine is very rare and potentially dangerous. CT and MRI are very useful and important for making a correct diagnosis. Prompt medical and surgical treatment may avert potential catastrophic event in these cases.
Authors:
Lei Wang; Limin Liu; Yueming Song; Fuxing Pei; Hao Liu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-18
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  -     ISSN:  1878-1632     ISO Abbreviation:  Spine J     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Elsevier Inc. All rights reserved.
Affiliation:
Department of Orthopedics, West China Hospital, Sichuan University, No.37, GuoXue Road, WuHou Zone, Chengdu, Sichuan 610041, China.
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