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Journal of Korean Neurosurgical Society 2007;42(5): 406-409.
doi: https://doi.org/10.3340/jkns.2007.42.5.406
Craniovertebral Junction Tuberculosis with Atlantoaxial Dislocation: A Case Report and Review of the Literature.
Dae Kyu Lee, Keun Tae Cho, So Hyang Im, Seung Koan Hong
Department of Neurosurgery, Dongguk University International Hospital, Goyang, Korea. ktcho21@naver.com
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.
Key Words: Tuberculosis; Craniovertebral junction; Atlantoaxial dislocation; Retropharyngeal abscess
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