Tuberculosis of the lower cervical spine (C3-C7) in adults: diagnostic and surgical aspects.

From 1976 to 1992, 160 cases of tuberculosis of the spine were treated at Jeanne Ebori Medical Center (Gabon); among whom 10 were localized to the lower cervical spine (C3-C7). From those 10 cases, 5 concerned children and had a medical treatment, whereas the remaining 5 cases concerned adults and underwent surgery (anterior approach), following an initial three-weeks course of antituberculous therapy. Prominent features of the disease in the 5 adult cases included neck pain and stiffness, neurological deficits and osteolytic erosions with myelographic block. The mean length of follow-up was 32 months (range: 8 to 96 months). All five patients improved their cord function and had a satisfactory bony consolidation. Socio-economic difficulties explain the necessity of reducing the treatment length by favoring surgical intervention in relatively advanced lesions.