Advertisement

Management of Craniovertebral Junction Tuberculosis Presenting with Atlantoaxial Dislocation

  • Granit MolliqajEmail author
  • Philipp Dammann
  • Karl Schaller
  • Ulrich Sure
  • Enrico Tessitore
Chapter
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 125)

Abstract

Tuberculosis (TB) rarely involves the craniovertebral junction (CVJ). Atlantoaxial dislocation (AAD) is one of the most commonly encountered lesions in craniocervical TB. The incidence of TB and its craniovertebral manifestation is increasing even in developed countries because of intercontinental migration and increased prevalence rates of immunosuppression conditions. While the treatment of craniovertebral TB is well standardized and relies on conservative measures, the treatment of TB with AAD is disputable. In this paper we present a review of the literature and elucidate our approach to craniovertebral TB with AAD through a case illustration.

Keywords

Tuberculosis Craniovertebral junction Atlantoaxial dislocation Craniocervical fixation 

Notes

Competing Interests

The authors declare that they have no competing interests.

Compliance with Ethical Standards

No financial support was received for this work.

References

  1. 1.
    Tuli SM. Tuberculosis of the craniovertebral region. Clin Orthop Relat Res. 1974;104:209–12.CrossRefGoogle Scholar
  2. 2.
    Lifeso R. Atlanto-axial tuberculosis in adults. J Bone Joint Surg Br. 1987;69(2):183–7.CrossRefPubMedGoogle Scholar
  3. 3.
    World Health Organization. Global tuberculosis report 2016. Geneva: World Health Organization, 2016.Google Scholar
  4. 4.
    Shukla D, et al. Management of craniovertebral junction tuberculosis. Surg Neurol. 2005;63(2):101–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Gokengin D, et al. The growing HIV epidemic in Central Europe: a neglected issue? J Virus Erad. 2016;2(3):156–61.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Gupta SK, et al. Tuberculosis of the craniovertebral junction: is surgery necessary? Neurosurgery. 2006;58(6):1144–50.CrossRefPubMedGoogle Scholar
  7. 7.
    Goel A. Tuberculosis of craniovertebral junction: role of facets in pathogenesis and treatment. J Craniovertebr Junction Spine. 2016;7(3):129–30.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Arora S, et al. The results of nonoperative treatment of craniovertebral junction tuberculosis: a review of twenty-six cases. J Bone Joint Surg Am. 2011;93(6):540–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Behari S, et al. Craniocervical tuberculosis: protocol of surgical management. Neurosurgery. 2003;52(1):72–81.PubMedGoogle Scholar
  10. 10.
    Teegala R, et al. Craniovertebral junction tuberculosis: a new comprehensive therapeutic strategy. Neurosurgery. 2008;63(5):946–55.CrossRefPubMedGoogle Scholar
  11. 11.
    Di Lorenzo N. Craniocervical junction malformation treated by transoral approach. A survey of 25 cases with emphasis on postoperative instability and outcome. Acta Neurochir (Wien). 1992;118(3–4):112–6.CrossRefGoogle Scholar
  12. 12.
    Arunkumar MJ, Rajshekhar V. Outcome in neurologically impaired patients with craniovertebral junction tuberculosis: results of combined anteroposterior surgery. J Neurosurg. 2002;97(2 Suppl):166–71.PubMedGoogle Scholar
  13. 13.
    Dhammi IK, Singh S, Jain AK. Hemiplegic/monoplegic presentation of cervical spine (C1–C2) tuberculosis. Eur Spine J. 2001;10(6):540–4.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Sinha S, et al. Surgical management and outcome of tuberculous atlantoaxial dislocation: a 15-year experience. Neurosurgery. 2003;52(2):331–89.CrossRefPubMedGoogle Scholar
  15. 15.
    Krishnan A, et al. Craniovertebral junction tuberculosis: a review of 29 cases. J Comput Assist Tomogr. 2001;25(2):171–6.CrossRefPubMedGoogle Scholar
  16. 16.
    Sharif HS, et al. Granulomatous spinal infections: MR imaging. Radiology. 1990;177(1):101–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Chandra SP, et al. Analysis of changing paradigms of management in 179 patients with spinal tuberculosis over a 12-year period and proposal of a new management algorithm. World Neurosurg. 2013;80(1–2):190–203.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Granit Molliqaj
    • 1
    Email author
  • Philipp Dammann
    • 1
    • 2
  • Karl Schaller
    • 1
  • Ulrich Sure
    • 2
  • Enrico Tessitore
    • 1
  1. 1.Department of NeurosurgeryGeneva University HospitalsGenevaSwitzerland
  2. 2.Department of NeurosurgeryUniversity Hospital EssenEssenGermany

Personalised recommendations