60 yr old male, k/c/o DM +HTN, Complaining of weakness in both lower and upper limbs and loss of sensations. Difficulty in speaking. Power in lower limbs 0/5 Upper limbs 3/5 Diagnosis? Management?



Destructive lesion of C7 vertebra with spondylolisthesis of C6UPON upon C7 with cord compression, indicative of myelomalacic changes, leading to quadriparesis. Most likely diagnosis is Koch's lesion, and needs cervical spine immobilisation by SOMI brace and adequate ATT. If no improvement is observed after 3-4 weeks of full course of ATT, then surgical decompression and internal stabilization of cervical spine is indicated.

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Odontoid is not seen well.part of C7 broken and move posteriorly compressing the cord,The marrow of moved part is well preserved. 1st and2nd images both are Tw.C3-4 there is osteophytic formation with narrow disc space.Cord is widened from C3 to C6and severely compressed atC7 with widening at D1.There is hyperintensity in the cord from C3 to C7 and w hypointensity at D1 level . Is there any history of trauma?Is there any history of primary malignancy? This is an old MRi done at 2018. No axial film posted. No contrast available also and hence difficult to interpret also Spinal bleed with edema vs mass lesion. Old case ,kindly give follow up

C6/7 anterolisthesis Kinking of cord with compression Upper limb partially spared because of level If no history of past trauma before onset consider other possibilities Go by radiologist report Need stabilization and decompression in any case Anterior corpectomy and fusion Neurological recovery doubtful

C6-7 cervical spine spondolisthesis with cord compression. Its very unstable and must be associated be bowel bladder involvement. Must be decompressed and fixed for good result. Need other images history and blood test to label it as Potts spine. Potts spine generally have have very good results when operated in time. Waiting for ATT to act might lead to permanent loss of neural tissue.

Thank you.

At C6-7 Cord compression with destructive lesion leading to quadriplegia. Need further evaluation Rx Refere to Orthopedic surgeon- spine and Neurosurgeon.

Usually in pots spine disc space is a common feature There's irregular destruction of anterior aspect of the vertebral body .I may also think in terms of osteolytic secondaries in the c spine .Cord compression needs decompressing and stabilization

I meant loss of disc space is a common feature in kochs

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C6 c7 compression C6 c7 partial corpectomy send c7 part for hpe Cervical cage with bone graft and plate fixation

Compressive myelopathy ? Koch's or 2ndy Urgent Surgical stabilization of cervical vertebra n treat primary cause Till time hard cervical collar

Agree w Dr.Jeetesh

Steriods&att later stabilization with bone graft with cage&fixation

Tuberculosis is not yet proven. Why wait for decompression? This is a neurosurgical emergency.
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