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TB is a re-emerging disease worldwide, affecting about one-third of the world's population, and second only to HIV/AIDS as the greatest killer worldwide. Skeletal TB constitutes 3-5% of all cases of TB, with cervical spine TB making up only 2-3% of cases of TB spine. Tuberculosis of the cranio-cervical junction is rare and accounts for only about 1% of all cases of spinal TB. Co-existence with pre or paravertebral abscess is rarer. We present a case of atlanto-axial and basi-occipital TB with a large paravertebral abscess and anterior epidural abscess without any neurological symptoms. To our knowledge this is the first such reported case in the literature. The patient was managed non-operatively using the middle path regimen with significant improvement in symptoms.
Keywords: Tuberculosis, spine, cervical, atlanto-axial, anti-tuberculosis theraoy, abscess, basi-occipital