Cervical spinal tuberculosis: Consistent imaging clues for early recognition from a case series

Background: Spinal tuberculosis is the most common form of musculoskeletal tuberculosis, although cervical spine involvement is relatively uncommon. It is clinically significant because even limited vertebral destruction may result in spinal cord compression and neurological deficits. Case Description: We report three patients in their late teens and twenties presenting with progressive neck pain and neurological symptoms. Radiographs demonstrated vertebral collapse and widening of the retropharyngeal soft-tissue space. Magnetic resonance imaging revealed extensive vertebral destruction with large paravertebral abscesses causing spinal cord compression. In one case, the disease extended into the cervicothoracic region with mediastinal involvement. The diagnosis was established through characteristic clinical and imaging findings and was microbiologically confirmed by GeneXpert detection of Mycobacterium tuberculosis . Conclusion: Cervical spinal tuberculosis should be considered in patients with persistent neck pain and neurological symptoms. Early recognition is critical to prevent spinal cord compression and irreversible neurological deficits.