19 Harley St, London, W1G 9QJ, UK

Pediatric cranio-vertebral junction tuberculosis: management and outcome.

Related Articles

Pediatric cranio-vertebral junction tuberculosis: management and outcome.

Childs Nerv Syst. 2013 May;29(5):809-14

Authors: Mehrotra A, Das KK, Nair AP, Kumar R, Srivastava AK, Sahu RN, Kumar R

INTRODUCTION: Tuberculosis (TB) of the cranio-vertebral junction (CVJ) is a rare condition, accounting for 0.3 % to 1 % of all cases of spinal TB. Early diagnosis and treatment are important in preventing long-term neurological sequelae. Management protocol of this rare site of TB is yet to be conclusively established. This holds particularly true for pediatric age group in which this condition is infrequently encountered.
MATERIALS AND METHODS: A total of 29 consecutive pediatric patients presented to the Department of Neurosurgery at Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, from January 1997 to October2011 with clinical and/or radiological features suggestive of CVJ TB. A clinical grading system to evaluate the neurological status was developed, and all patients were evaluated using this scoring system. Patients were radiologically evaluated with computed tomography (CT) of CVJ and magnetic resonance imaging (MRI) with gadolinium enhancement. These cases were managed according to their grade and followed up.
RESULTS: Out of a total of 29 cases, 18 were females and 11 males. Age range was 4 to 18 years with mean age 9?±?3.8 years. The follow-up period ranged from 2 months to 7.5 years with mean follow-up of 2.7 years. Eleven cases were of grades 1 and 2, and 18 cases were of higher grade (grades 3 and 4). Predominantly conservative approach was utilized in cases with better clinical status, and grade (grades 1 and 2) and surgical intervention was needed in the more severe grades. All cases had significant improvement at the last follow-up.
CONCLUSION: One needs to have a high index of suspicion of CVJ TB if one encounters a case with neck pain, neck restriction, and raised erythrocyte sedimentation rate. CT CVJ and MRI with gadolinium contrast enhancement are the investigations of choice for both establishing a diagnosis and planning the management. For cases with mild neurological deficit, conservative approach would work for majority of cases, and for severe cases, initial conservative approach may be tried, failing which surgical intervention would be needed.

PMID: 23274634 [PubMed – indexed for MEDLINE]

Pediatric cranio-vertebral junction tuberculosis management and outcome | Scoliosis specialist london

What our patients say ...

Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Surgeon
Consultant Spinal Anaesthetist

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810