Cervicothoracic Tuberculous Spondylitis in a Toddler: A Case Report.

Background and Importance Tuberculous spondylitis (or Pott's disease) is a common form of skeletal tuberculosis. Although primarily treated with tuberculostatic drugs, spinal surgery is necessary in patients with deformities or spinal cord compression. Literature describing surgery strategies in very young children remains scarce. Clinical Presentation A 20-month-old girl presented with torticollis without neurological deficits. Magnetic resonance imaging showed a cavitating mass, with destruction of the C7, T1, and T2 vertebrae. A combined anterior cervical and sternotomy approach was used to rest the tuberculoma, after which an allograft fibula was placed in the gap. An anterior plate was placed. The posterior elements were opened to induce fusion. Neurological status remained unchanged, but after 6 weeks, the allograft was displaced, resulting in kyphosis. This kyphosis remained unchanged, and fusion of the posterior elements developed in the following months. Conclusion Combined anterior cervical and sternotomy approach and additional posterior fusion induction is a feasible surgical strategy for tuberculoma resection of the cervicothoracic spine. In the postoperative course, close monitoring should be performed to detect progressive kyphosis in an early stage.