Tuberculosis of the Subaxial cervical spine: a case series from Tema, Ghana.
BACKGROUND
Tuberculosis (TB) is endemic in West Africa. However, TB of the cervical spine is rare.


OBJECTIVE
To report a series of patients with TB of the sub-axial cervical spine (SACS), in order to illustrate its presentation, treatment and outcome.


METHODS
The patients were studied with respect to clinical history and physical examination. Laboratory tests, plain cervical spine X ray studies and myelography with post-myelographic CT scans were used for diagnosis. All patients underwent surgery and antituberculous therapy (ATT). Histopathologic results of surgical specimens were also analysed.


RESULTS
All the patients were male and presented with severe neck pain and long tract signs. Osteomyelitis of the SACS was evident with disc space involvement and prevertebral soft tissue swelling. None of the patients had a history of pulmonary TB or TB meningitis; none had a positive Mantoux test. All patients improved neurologically after surgery and ATT.


CONCLUSIONS
Although tuberculosis of the cervical spine is rare, the possibility of the disease should be considered when patients from areas in which the disease is endemic report with severe neck pain. Surgery could be indicated in cases with associated neurologic deficit and or spinal column instability. Anti-tuberculosis therapy should be continued for at least six months.
Andrews
N B
NB
TEMA International Neurocenter (T.I.N.), NARH-BITA Hospital, TEMA. nbandrews@hotmail.com
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology; D019299:Decompression, Surgical; D005869:Ghana; D006801:Humans; D008297:Male; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000209:etiology; D013123:Spinal Fusion; D013131:Spine / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
D000995:Antitubercular Agents