PMC4513297_01
On magnetic resonance imaging of cervical spine shows irregular lytic bony destruction C-1, C-2, and occipital condyle, with cranial migration of odontoid with tip up to the level of foramen magnum, compression of cord with cord edema, suggestive of Koch's
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F1
On magnetic resonance imaging of cervical spine [Figure 1], there were irregular lytic bony destruction in anterior arch and left lateral mass of C-1, left occipital condyle, left half of C-2 vertebra with prevertebral and left para vertebral collection, mild erosion in the odontoid process, with cranial migration of odontoid with tip up to the level of foramen magnum, there was compression of cord at this level with cord edema, suggestive of Koch's.
Posterior occipitocervical fusion
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F2
We did a transoral decompression of abscess with biopsy along with posterior decompression of cord and occipitocervical fusion [Figure 2].