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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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References

1Behari, S, Nayak, SR, Bhargava, V, Banerji, D, Chhabra, DK, Jain, VK. Craniocervical tuberculosis: protocol of surgical management. Neurosurgery 2003;52:72–80Google ScholarPubMed
2Kassam, AB, Snyderman, C, Gardner, P, Carrau, R, Spiro, R. The expanded endonasal approach: a fully endoscopic transnasal approach and resection of the odontoid process: technical case report. Neurosurgery 2005;57(Suppl. 1):E213Google ScholarPubMed
3Sakou, T, Morizono, Y, Morimoto, N. Transoral atlantoaxial anterior decompression and fusion. Clin Orthop Relat Res 1984;187:134–8CrossRefGoogle Scholar
4Alfieri, A, Jho, HD, Tschabitscher, M. Endoscopic endonasal approach to the ventral cranio-cervical junction: anatomical study. Acta Neurochir (Wien) 2002;144:219–25Google Scholar
5Kingdom, TT, Nockels, RP, Kaplan, MJ. Transoral-transpharyngeal approach to the craniocervical junction. Otolaryngol Head Neck Surg 1995;113:393–400Google Scholar
6Wolinsky, JP, Sciubba, DM, Suk, I, Gokaslan, ZL. Endoscopic image-guided odontoidectomy for decompression of basilar invagination via a standard anterior cervical approach. J Neurosurg Spine 2007;6:184–91CrossRefGoogle Scholar