Surgical correction of severe cervical kyphosis secondary to tuberculoid Pott's disease: illustrative case.

Abstract

Background: Pott's disease (PD) is an infection of the vertebral bodies due to Mycobacterium tuberculosis. Commonly presenting with back pain, the insidious nature of the disease can result in the development of kyphotic deformities, epidural collections, and neurological dysfunction. The authors describe the case of a 21-year-old male who presented with symptoms of cervical myelopathy and was found to have a kyphotic deformity involving the C5 and C6 vertebrae with epidural extension. The patient was treated with a combined anterior-posterior surgical approach: anteriorly with C5-6 corpectomy and cage placement and posteriorly with C2-T2 instrumentation. The final pathology was positive for M. tuberculosis, and the patient was placed on antibacterial therapy.

Observations: PD often presents late with symptoms that do not match the severity of the radiological spinal deformities. Surgical intervention is warranted in patients with severe deformity, neural element compression, and concordant neurological deficits. A literature review demonstrated that the combined anterior-posterior approach provides the greatest correction of kyphotic deformities. However, both anterior and combined approaches are associated with good outcomes and relatively few surgical complications.

Lessons: The combined anterior-posterior surgical approach for cervical PD is recommended when kyphosis is severe. With appropriate surgical and medical management, most patients recover well without recurrence of symptoms. https://thejns.org/doi/10.3171/CASE24652.