title: Craniocervical junction tuberculosis: Usual pathology at an unusual site.
abstract: BACKGROUND
  Tuberculosis (TB) of the craniocervical junction is rare even where the condition is endemic. It poses problems in both diagnosis and management if not managed in time it may cause life-threatening complications.
  
  
  METHODS
  An 18-year-old male patient presented with pain in the nape of the neck since 12 months duration which was not improving with medication. After magnetic resonance imaging of cervical spine, he was diagnosed as craniocervical junction TB. We did a transoral decompression of abscess with biopsy along with posterior decompression of cord and occipitocervical fusion. Biopsy of pathological material came as TB. He was advised for anti-tubercular therapy for 18 months.
  
  
  CONCLUSIONS
  Although craniocervical junction TB is a rare disease, the outcome of treatment is good. Antituberculous drug therapy remains the mainstay of treatment after confirming the diagnosis. The surgical management options include transoral decompression with or without posterior fusion, depending upon the presence and persistence of atlantoaxial instability.
authors.affiliation: Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India.
authors.forename: Biswaranjan
authors.initials: B
authors.lastname: Nayak
authors.affiliation: Department of Orthopaedics, Apollo Hospital, Bhubaneswar, Odisha, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Patnaik
authors.affiliation: Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India.
authors.forename: Prafulla Kumar
authors.initials: PK
authors.lastname: Sahoo
authors.affiliation: Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Biswal
keywords: Craniocervical junction; posterior fusion; transoral decompression; tuberculosis