Craniovertebral Junction Koch spine – an unusual presentation treated with a novel approach: case report and review of literature

The retropharyngeal space lies in the posterior pharyngeal wall between the middle and deep layers of the deep cervical fascia. It extends from the base of the skull to the mediastinum and frequently serves as a conduit for spread of disease from the neck into the chest. Spinal tuberculosis is the commonest extra pulmonary manifestation of tuberculosis. Clinical findings of cervical tuberculosis includes neck pain, restricted neck movements, quadriparesis, radicular manifestations, kyphosis, and sensory disturbance. It should be suspected in an adult person who presents with a destructive lesion of the cervical vertebra and retro-pharyngeal mass. Early diagnosis and treatment are necessary to prevent the serious complications of the disease. We present here a 46 years old female who presented to a tertiary care setup with acute onset dyspnea and quadriplegia with bladder bowel involvement managed with trans oral incision and drainage of retropharyngeal abscess followed by posterior occipitocervical fusion supplemented with Anti Koch Therapy with a good follow up