SUB OCCIPITAL POTTSS DISEASE - CASE-REPOR T AND LITERATURE-REVIEW

Introduction A new case of sub-occipital Potts disease is reported. Ca se report A 26 years old female from Senegal was admitted for cervical pain of three months duration, neck stiffness and left nasal obstruct ion with Arnold neuralgia.Radiological studies found a C-1-C-2 rotator y subluxation with an osteolytic erosion of the lateral mass of the at las and destruction of the left atlanto-axial joint. CT scan and magne tic resonance imaging provided important diagnostic clues. Culture of sinus biopsies showed a mycobacterium tuberculosis. Progressive reduct ion of the dislocation and immobilization by minerva jacket for six mo nths with prolonged antituberculous chemotherapy provided successful e nd result. Discussion A review of the literature found 95 cases report ed since the beginning of this century. The mean age was 20-30 years o ld. A finding of acid resistant bacilli is necessary for diagnosis and requires culture of gastric secretion, expectoration, retro pharyngea l mass puncture and other upper respiratory tract foci. Radiological s igns are discussed. Chemotherapy is the mainstay of treatment with imm obilization following reduction of the dislocation when present. The r emoval of abscess is discussed as well as bone grafting by an anterior or more commonly by posterior approach in case of instability.