PMID: 25775729Mar 18, 2015Paper

Cervical spinal tuberculosis: a preliminary study of clinical diagnosis and management

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
Torphong Bunmaprasert, Kittipong Dongsang

Abstract

Cervical involvement in spinal tuberculosis is rare; however delayed diagnosis and treatment may result in massive, irreversible neurological deterioration. The purpose of this study is to report on a strategy for clinical diagnosis and management of cervical spinal tuberculosis. Eighteen patients (13 males and 5 females) during 1998-2013 were retrospectively reviewed at Chiang Mai University Hospital. The patients had a mean age of 51.4 years (range 37-68 years). History, examination, radiographs, MRI and tissue sampling were used in diagnosis. Most of the patients were given antituberculous therapy (ATT) and underwent surgical management. The mean follow-up period was 12.8 months. Axial neckpain, quadriparesis, spastic gait and hand clumsiness were the predominant symptoms. Disc narrowing, endplate destruction andparaspinal soft tissue swelling were the prominent radiographic findings. MRI found Gadolinium enhancement of prevertebral soft tissue, T2 hypersignal of the intervertebral discs, intraosseous T2 hypersignal at the vertebral body, and disc fragmentation. Thirteen patients underwent single-stage anterior debridement with fusion. Three patients underwent posterior fusion alone. Axial neck pain improved in all patients....Continue Reading

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