Retrospective study of spinal tuberculosis from 1991- 2001

1. Management of tuberculosis of
cervicothoracic junction
Amit Agrawal

2.  Retrospective study of spinal tuberculosis from 1991- 2001
 Total no. of cases- 238
 Cervicothoracic junction (C7-T3) involvement - 29 cases
(12%)
Materials and methods

3. Age distribution
(n-29)
0
2
4
6
8
10
12
0-10 11--20 21-30 31-40 41-50 51-60

4. Sex distribution
(n-29)
0
2
4
6
8
10
12
14
16
18
Male Female

5.  Myelopathy- 17
 Myeloradiculopathy- 10
 Radiculopathy- 2
 Sphincter disturbances- 4
 Tenderness- 20
 Deformity- 16
Clinical presentation

6.  X ray - all cases
 Myelogram- 5
 CT scan- 12 cases
 MRI- 11 cases
Imaging

7. Number of vertebrae involved
0
2
4
6
8
10
12
14
16
1 2 3 4 5
Mean level of involvement- 1.8 vertebrae

8.  Anterior involvement- 11
 Posterior involvement- 1
 Cord compression- 10
 Cold abscess- 12
Imaging findings

9.  Tubercular granulation tissue- 19
 Tubercular osteomyelitis- 10
Histopathology
(n-29)

10.  CT guided biopsy- 2
 Decompression alone- 10
 Decompression with bone
graft fusion- 6
 Decompression with
fusion and fixation- 11
Management
(n-29)

11. Surgical Approaches-
Anterior - 17
Posterior - 8
Combined – 2
All the patients received ATT
Management

29.  18 cases available for follow up
 Mean follow up - 9.3 months
(2- 36 months)
 All improved neurologically and were independent
Outcome
(n-29)

30.  Difficult management
 Requires proper surgical planning and approach
 ATT required in all cases
 Good outcome
Conclusion