One-stage anterior approach for long-segment subaxial cervical spondylitis tuberculosis: A case report

• Main Author: Eko Agus Subagio, Eko
• Format: Article PeerReviewed
• Language: English; English; English
• Published: Elsevier 2022
• Subjects: R5-920 Medicine (General); RD520-599.5 Surgery by region, system, or organ
• Online Access: https://repository.unair.ac.id/128244/1/1-s2.0-S2210261222009397-main.pdf; https://repository.unair.ac.id/128244/2/08%20-%20One-stage%20anterior%20approach%20for%20long-segment%20subaxial%20cervical%20spondylitis%20tuberculosis%20A%20case%20report.pdf; https://repository.unair.ac.id/128244/3/08%20-%20One-stage%20anterior%20approach%20for%20long-segment%20subaxial%20cervical%20spondylitis%20tuberculosis%20A%20case%20report.pdf; https://repository.unair.ac.id/128244/; https://doi.org/10.1016/j.ijscr.2022.107693; https://doi.org/10.1016/j.ijscr.2022.107693
• Institution: Universitas Airlangga

Background: Spondylitis TB on cervical region is a rare disease, that may lead to severe neurological complications. The anterior approach is considered as a gold standard for cervical spine tuberculosis. Available studies and literature have not precisely mentioned on how many levels are acceptable for this disease and still up for discussion. Case presentation: A 45-year-old Asian male was brought from a rural hospital to our outpatient clinic with progressive weakness of all extremities for 3 months. Cervical x-ray and MRI showed three-levels of vertebral body destruction, suggesting a cervical spondylitis TB. Patient had debridement, corpectomy on C4, 5, 6, fusion with cage, and anterior plating from C3 to Th1 in a one-stage anterior approach. Immediately after the surgery, the patient had no complaints of pain, and he was able to walk on his own. One year follow-up after the surgery, no residual neurological impairment is detected and had no limitation in daily activities. Cervical x-ray and MRI showed good ossification and improvement of lordotic curvature. Conclusion: Treatment of cervical spondylitis TB which involved three-levels of vertebrae using one-stage anterior approach provides a good rate of deformity correction along with clinical improvement and long-term well-being of the patient.