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Endoscopic, endonasal decompression of spinal stenosis with myelopathy secondary to cranio-vertebral tuberculosis: two cases

Published online by Cambridge University Press:  11 December 2009

P Puraviappan ,
I P Tang ,
D J Yong ,
N Prepageran ,
R L Carrau  and
A B Kassam
P Puraviappan
Affiliation:
ORL Department, Faculty of Medicine, University Putra Malaysia, Selangor, Malaysia
I P Tang*
Affiliation:
ORL Department, Faculty of Medicine, University Malaysia Sarawak, Sarawak, Malaysia
D J Yong
Affiliation:
ORL Department, General Hospital Kuala Lumpur, Malaysia
N Prepageran
Affiliation:
ORL Department, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
R L Carrau
Affiliation:
Department of Neurosurgery and Otolaryngology, University of Pittsburgh Medical Center, Pennsylvania, USA
A B Kassam
Affiliation:
Department of Neurosurgery and Otolaryngology, University of Pittsburgh Medical Center, Pennsylvania, USA
*
Address for correspondence: Dr Ing Ping Tang, 66 Lorong Setia Raja 12A1, Taman Stutong Indah, 93350 Kuching, Sarawak, Malaysia. Fax: 6082422564 E-mail: ingptang@yahoo.com
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Abstract

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.

Aim:

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.

Study design:

Two case reports.

Methods and results:

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

Conclusion:

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.

Keywords

EndoscopicEndonasal Spinal DecompressionSpinal StenosisCraniovertebralTuberculosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 7 , July 2010 , pp. 816 - 819
Copyright
Copyright © JLO (1984) Limited 2009

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