27/02/2026
A 68year-old gentleman initially presented with what appeared to be mechanical neck pain. He was treated conservatively, but instead of improving, his pain kept worsening. Gradually, he became almost bed-bound due to severe neck pain and functional limitation.
Further evaluation with MRI revealed C1–C2 instability with arthritic changes. Considering the severity of instability and his deteriorating condition, we proceeded with C1–C2 fixation surgery.
Intraoperatively, we encountered an unexpected finding — pus within the atlantoaxial joint. Samples were sent for analysis, and the final diagnosis confirmed tubercular infection of the C1–C2 joint.
Post-surgery, the transformation was remarkable.
His neck pain completely resolved.
His neurological status improved significantly.
Within a week he walked without support.
Seeing him walk confidently, smiling, with his family relieved and grateful — that is the true reward of our profession.
This case is a reminder:
Persistent neck pain that does not improve deserves deeper evaluation.
Spinal tuberculosis can sometimes present in subtle and misleading ways.
Timely diagnosis and appropriate surgical intervention, combined with anti-tubercular therapy, can be life-changing.
Moments like these strengthen our commitment to patient care. -c2 fixation surgery
