Early Surgical Management Outcomes in Cervical Spine Tuberculosis: A Case Series from Sabah, Malaysia

Chin Pei Bong, Jimmy Teik Loong Lim, Choong Hoon Foo, Marazuki Hp, Chung Chek Wong

Abstract: Cervical spine tuberculosis (CSTB), accounting for 3-5% of all spinal tuberculosis cases, is rare but can lead to catastrophic consequences owing to its specific anatomy, making it prone to instability and neurological compromise. Despite its rarity, there is ongoing debate over the early surgical management of cervical tuberculosis. This study evaluates the outcomes of early surgical management in six patients with CSTB treated in Kota Kinabalu, Sabah, Malaysia, from 2017 to 2020. The patients, comprising four males and two females with a median age of 51, exhibited pre-operative neck pain and neurological deficits. Surgical approaches varied based on disease severity and anatomical considerations. Despite one post-operative death and one implant failure, most patients showed significant improvement in symptoms and neurological function. Our findings underscore the importance of combining medical and surgical treatments in the early stages of CSTB to prevent severe outcomes.

Keywords: cervical spine tuberculosis, early surgical management, cervical instability, neurological outcomes, Sabah tuberculosis cases