The patient is taken to the OR and undergoes a C5 and C6 corpectomy with reconstruction using a fibular allograft and anterior cervical plate. His neck pain improves and he is discharged home after 3 days.
Intra-operative specimens are taken.
Pathology reveals: chronic inflammation and granulation tissue; focal osteoclastic resorption, foci of chronic inflammation including macrophages and PMN; no eosinophils seen; CD1a immunostain negative on decalcified tissue.
Microbiology: negative for any organisms.
Figure 3. CT C spine without contrast.
1. What is your most likely diagnosis?
2. What is the next step in your management?
3. What is your next step in his management?
4. What would be your surgical plan for this patient?
5. Please add any suggestions or comments regarding this case:
He needs an MRI of the brain to evaluate for a cause for the bruises. He may have had a seizure.
make sure that the patient is off of coumadine and cardiaology to help with AFIB management since this patient will be off of coumadine at least for 4-6 weeks.
Case of TB cervical spine with paraspinal abscess. Possibility of conservative management with ATT is biopsy of tissue is positive for AFB and culture also is positive for AFB, otherwise surgical debridement and fusion.