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

• Main Authors: Puraviappan, P., Tang, I.P., Yong, D.J., Prepageran, N., Carrau, R.L., Kassam, A.B.
• Format: Article
• Published: Cambridge University Press 2010
• Subjects: R Medicine
• Online Access: http://eprints.um.edu.my/13119/; https://doi.org/10.1017/S0022215109992271

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.