J Bone Jt Infect 2016; 1:31-33. doi:10.7150/jbji.15884
Short Research Communication
Tuberculous Spondylitis of the Craniovertebral Junction
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece.
Megaloikonomos PD, Igoumenou V, Antoniadou T, Mavrogenis AF, Soultanis K. Tuberculous Spondylitis of the Craniovertebral Junction. J Bone Jt Infect 2016; 1:31-33. doi:10.7150/jbji.15884. Available from http://www.jbji.net/v01p0031.htm
Craniovertebral junction tuberculosis is rare, accounting for 0.3 to 1% of all tuberculous spondylitis cases. MR imaging is the modality of choice to detect bone involvement, abscess formation and subligamentous spreading of the pus, to differentiate from other lesions affecting the craniovertebral junction, and to determine the efficacy of treatment. Given the fact that surgical treatment of patients with craniovertebral junction tuberculosis has been associated with a high mortality rate ranging up to 10% and recurrence rate ranging up to 20%, conservative is the standard of treatment for most patients.
This article presents a patient with craniovertebral junction Mycobacterium tuberculosis infection diagnosed with CT-guided biopsy. A halo vest was applied and antituberculous treatment with rifampicin, isoniazid and ethambutol was initiated. At 6-month follow-up, the patient was asymptomatic; CT of the cervical spine showed healing of the bony lesions. The halo vest was removed and physical therapy was recommended. Antituberculous treatment was continued for a total of 18 months, without any evidence of infection recurrence
Keywords: Tuberculous Spondylitis, Craniovertebral Junction.