Abstract
Background: Tuberculosis of the spine is common in Nigeria. It commonly causes neurological deficit especially when the lesions are higher up in the spine. Objective: To report a case of a young man who had C4 quadriplegia from tuberculous destruction of C3 to C5 vertebral bodies and their intervening discs, aretropharyngeal prevertebral abscess and associated segmental kyphosis. He had received prior antituberculous therapy with no improvement. Results: He recovered completely neurologically when he had adequate decompression and 360°; instrumented fusiondone in a 3-stage surgery that involved drainage and debridement of the retropharyngeal prevertebral abscess, anterior corpectomy of C3 and C4 with fusion using a titanium mesh cage, and posterior fusion of C3 to C6 using titanium rods and lateral mass screws. Surgical treatment was supported with skull traction and antituberculous therapy. Conclusion: This case shows that complete neurologic recovery is feasible in spinal quadriplegia that fails to respond to antituber-culous therapy when adequate decompression and fusion are done.
Highlights
Tuberculosis of the spine has been recognized since as far back as 100-300 BC when Hippocrates first described the disease [1]
Spinal tuberculosis is the commonest cause of kyphosis in many parts of the world and this kyphosis tends to be the rule rather than the exception [1] [14]
Surgical treatment of spine tuberculosis has evolved over the years [1] and has a role in patients with neurological deficit, spine deformities and instability, large paraspinal collections, and where chemotherapy fails [2] [3]
Summary
Tuberculosis of the spine has been recognized since as far back as 100-300 BC when Hippocrates first described the disease [1]. Known as Pott’s disease [2] and tuberculous spondylitis, the incidence of the condition varies throughout the world [3], being common in Nigeria [4]. Neurological deficits are a common complication of the disease with the frequency increasing with higher lesions [1] [3] [6]. Decompressive surgery along with antituberculous therapy is the best mode of treatment for the disease [7], though patients with no or minimal neurological deficit are known to have been managed non-surgically [8]. This report highlighted the case of a young man who had tuberculous quadriplegia
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