[Tuberculous spondylitis of the cervical spine]

WHO estimates that worldwide more than 4 million people are infected with tuberculosis (TB), 95% of them living in third world countries. TB is once again the most frequent infectious disease [1, 2, 7]. Extrapulmonary forms (EPTB) frequently appear with HIV-associated TB [3, 4, 6]. We present the case of a 23-year old patient with abscess forming TB of the right apical lung with infiltration and partial osteolytical destruction of the 7th cervical- and the first thoracal vertebral body. Progressive spinal compression lead to partial sensomotorical deficits. Surgical revision of the abscess, an atypical resection of the right apical lung and right wing hemilaminectomy of Th1/2 for spinal decompression became necessary. The spinal stabilisation was achieved by conservative treatment for 6 weeks only by a Minerva cast and for another 8 weeks by a cervical stiffneck. Following mobilisation was without problems and the neurological deficits subsided within 3 months. Clinical examination and functional X-rays analysis proved vertebral stability and good function. The treatment of TB is basically conservative. Surgery is only recommended in case of functional and infectious complications.