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Skeletal Radiology

, Volume 47, Issue 5, pp 723–727 | Cite as

Unusual circumstances to diagnose cervical Pott’s disease

  • Mohamed Ali Kedous
  • Ahmed Msakni
  • Wael Chebbi
  • Mourad Zaraa
  • Mohsen Trabelsi
Case Report

Abstract

Tuberculous spondylodiscitis usually affects the dorso-lumbar spine, and its cervical location is a rare condition that can mimic other diseases and consequently cause treatment delays. We report a case of tuberculous spondylodiscitis of the lower cervical spine discovered under unusual circumstances in a patient with severe polytrauma involving a cranio-cerebral trauma, a non-displaced fracture of the two laminæ and the spinous process of the C6 vertebrae as well as fibular and tibial shaft fractures. The patient underwent static tibial nailing, and a collar with occipital and chin supports was applied. At 2-month follow-up, the patient presented with severe neck pain without neurologic deficits. Plain and dynamic cervical radiographs showed a stable C6-C7 subluxation and C7 superior endplate collapse. The CT scan also outlined prevertebral soft tissue swelling. The MRI showed a C6–C7 spondylodiscitis associated with a prevertebral abscess with am 8-cm major axis. The diagnosis of C6–C7 Pott’s disease was confirmed by a CT-guided biopsy. The patient received 12 months of antituberculous chemotherapy, after which the paravertebral abscess completely disappeared, and the patient has had no functional sequelae. The diagnosis of cervical spine tuberculosis is difficult and requires a high level of attention. Delays in establishing the diagnosis and starting the appropriate treatment result in severe complications such as spinal cord compression and spinal deformity, which are difficult to manage.

Keywords

Pott’s disease Tuberculosis Cervical spine CT scan MRI 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Alam MS, Phan K, Karim R, Jonayed SA, Munir HKM, Chakraborty S, et al. Surgery for spinal tuberculosis: a multi-center experience of 582 cases. J Spine Surg. 2015;1(1):65.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Mao N, Shi Z, Ni H, Zhao Y, Tang H, Liu D, et al. Long-term outcomes of one-stage anterior debridement, bone grafting, and internal fixation for the treatment of lower cervical tuberculosis with kyphosis. Br J Neurosurg. 2013;27(2):160–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Morris B, Varma R, Garg A, Awasthi M, Maheshwari M. Multifocal musculoskeletal tuberculosis in children: appearances on computed tomography. Skelet Radiol. 2002;31(1):1.CrossRefGoogle Scholar
  4. 4.
    Nigro L, Tarantino R, Donnarumma P, Santoro A, Delfini R. A case of cervical tuberculosis with severe kyphosis treated with a winged expandable cage after double corpectomy. J Spine Surg. 2017;3(2):304.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Marom EM, Porter A, Gornish M, Cohen M, Russo I. Atypical skeletal tuberculosis. Skelet Radiol. 1995;24(8):620–2.CrossRefGoogle Scholar
  6. 6.
    Rathakrishnan V, Mohd TH. Osteo-articular tuberculosis. Skelet Radiol. 1989;18(4):267–72.CrossRefGoogle Scholar
  7. 7.
    He M, Xu H, Zhao J, Wang Z. Anterior debridement, decompression, bone grafting, and instrumentation for lower cervical spine tuberculosis. Spine J. 2014;14(4):619–27.CrossRefPubMedGoogle Scholar
  8. 8.
    Moon MS, Kim SS, Lee BJ, Lin JF. Tuberculosis of the spine: evolution in diagnosis and management. ArgoSpine News J. 2011;23(3):90–8.CrossRefGoogle Scholar
  9. 9.
    Boussel L, Marchand B, Blineau N, Pariset C, Hermier M, Picaud G, et al. Imagerie de la tuberculose ostéo-articulaire. J Radiol. 2002;83(9-C1):1025–34.PubMedGoogle Scholar
  10. 10.
    Rasouli MR, Mirkoohi M, Vaccaro AR, Yarandi KK, Rahimi-Movaghar V. Spinal tuberculosis: diagnosis and management. Asian Spine J. 2012;6(4):294–308.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Jain A. Tuberculosis of the spine. Bone & Joint Journal. 2010;92(7):905–13.Google Scholar
  12. 12.
    Zhang HQ, Lin MZ, Li JS, Tang MX, Guo CF, Wu JH, et al. One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series. Arch Orthop Trauma Surg. 2013;133(3):333–41.CrossRefPubMedGoogle Scholar
  13. 13.
    Phan K, Tian DH, Cao C, Black D, Yan TD. Systematic review and meta-analysis: techniques and a guide for the academic surgeon. Annals of cardiothoracic surgery. 2015;4(2):112.PubMedPubMedCentralGoogle Scholar

Copyright information

© ISS 2017

Authors and Affiliations

  1. 1.Trauma CenterBen ArousTunisia
  2. 2.Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia

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