Endoscopic, endonasal decompression of spinal stenosis with myelopathy secondary to cranio-vertebral tuberculosis: two cases.
BACKGROUND
Tuberculosis can cause extensive osseo-ligamentous destruction at the cranio-vertebral junction, leading to atlanto-axial instability and compression of vital cervico-medullary centres. This may manifest as quadriparesis, bulbar dysfunction and respiratory insufficiency.


OBJECTIVE
We report two patients presenting with spinal stenosis and cord compression secondary to cranio-vertebral tuberculosis, who were successfully decompressed via an endoscopic, endonasal approach.


METHODS
Two case reports.


RESULTS
Both patients were successfully decompressed via an endoscopic, endonasal approach which provided access to the cranio-vertebral junction and upper cervical spine.


CONCLUSIONS
An endoscopic, endonasal approach is feasible for the surgical management of cranio-vertebral junction stenosis; such an approach minimises surgical trauma to critical structures, reducing post-operative morbidity and the duration of hospital stay.
Puraviappan
P
P
ORL Department, Faculty of Medicine, University Putra Malaysia, Selangor, Malaysia.
Tang
I P
IP
Yong
D J
DJ
Prepageran
N
N
Carrau
R L
RL
Kassam
A B
AB
D000328:Adult; D001268:Atlanto-Axial Joint / Q000601:surgery; D002574:Cervical Vertebrae / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery; D012886:Skull; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery*; D013130:Spinal Stenosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000150:complications*; D014399:Tuberculosis, Spinal / Q000150:complications