ISPUB.COM The Internet Journal of Neurosurgery Volume 6 Number 2 1 of 4 conservative treatment of large tubercular abscess arising from spinous process and laminae S Kumar, P Abbey, V Jaiswal Citation S Kumar, P Abbey, V Jaiswal. conservative treatment of large tubercular abscess arising from spinous process and laminae. The Internet Journal of Neurosurgery. 2008 Volume 6 Number 2. Abstract Posterior spinal tuberculosis is rare. A case of posterior spinal tuberculosis with large abscess without any neurological deficit was managed conservatively. He was relieved of pain and swelling subsided completely on anti-tubercular drugs INTRODUCTION The characteristic picture of spinal tuberculosis consists of destruction of adjacent vertebral bodies and the intervening disc. Rarely the tuberculosis may affect the posterior elements i.e neural arch without affecting the body. We came across a large tubercular abscess arising from the spinous process and the laminae of C3 vertebra which was managed conservatively. Because of its rare location , it is being reported. CASE REPORT A 39-year-old male attended neurosurgical service with complaints of swelling in the nape of neck of three months duration.On iterrogation he complained of mild pain in the nape of neck. There was no history of trauma or fever. There was no history weakness in the limbs, bladder or bowel disturbances. On examination there was diffuse swelling over the nape of neck extending occiput to C7 spinous process. It was non-tender , ill defined and cystic in nature. There was no neurological deficit in the limbs. Haemogram, blood chemistry, urine analysis and chest X- ray were normal. ESR was 10mm in the 1 st hour. Montoux test was not done. X-ray cervical spine revealed destruction of C3 spinous process and soft tissue shadow posteriorly (Fig 1). Figure 1 Figure 1: Lateral view of X-Ray cervical spine showing destruction of spinous process of C 3 vertebra Computed tomography revealed destruction of spinous process and laminae and large abscess in the intermuscular plain and small amount of granulation tissue in the epidural space posteriorly (Fig 2).