Neonatal C1 to C2 Osteomyelitis Leading to Instability and Neurological Decline

Glotzbecker, Michael P.; Wasser, Aubrey M.; Troy, Michael; Proctor, Mark R.; Emans, John B.

doi:10.1097/bpo.0000000000000309

Cited by 10 publications

(6 citation statements)

References 33 publications

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“…Although rare, some cases of pediatric spinal infections do require surgical intervention, and those cases are crucial to identify. Generally, surgery is reserved for patients displaying progressive neurologic deficit or progressive instability [ 38 ]. The indications for decompression and atlantoaxial fusion for cervical spine tuberculosis in children are neurologic deficit, atlantodental interval greater than 5 mm on flexion/extension views, and progressive deformity [ 37 ].…”

Section: Reviewmentioning

confidence: 99%

“…A novel surgical treatment of a three-month-old infant with vertebral osteomyelitis displaying neurological decline from progressive instability of the occiput, C1, and C2 levels after failed bracing was described [ 38 ]. The patient had reduction and occiput to C2 posterior fusion and segmental instrumentation, with nonsegmental instrumentation extending in the soft tissues from C2 to T4 with the intent of providing stabilization without fusion and permitting further growth.…”

Section: Reviewmentioning

confidence: 99%

“…Patients with spondylodiscitis of the thoracic or lumbar spine are at the risk of developing scoliosis or kyphosis, sometimes requiring surgical correction [ 7 , 24 ]. Glotzbecker et al noted in their case report of neonatal axial spine osteomyelitis that the patients continued to have mild global developmental delay two years following successful hardware removal [ 38 ]. Historical literature has shown that non-surgical management of spinal infections in children frequently leads to paraplegia [ 27 ] and was routinely fatal [ 30 ], but the adoption of modern practices has led to massive improvements in both morbidity and mortality.…”

Section: Reviewmentioning

confidence: 99%

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The Diagnosis and Management of Pediatric Spine Infections

Saleh

Vasileff

Omari

et al. 2021

Cureus

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The management of pediatric spine infections requires a multidisciplinary approach that includes orthopedic surgeons, infectious disease specialists, interventional radiologists, and others. The prevalence of the disease has increased in frequency, virulence, and degree of soft tissue involvement over the past several years; there has also been a resurgence of some types of infections, such as tuberculosis, fungal, and viral pathogens. The diagnosis can often be reached with a detailed history, physical examination, laboratory tests, and imaging studies. Pathologies mimicking infection require a more invasive approach for diagnosis, including core or open biopsy. The treatment of discitis, spondylodiscitis, vertebral osteomyelitis, spinal epidural, and intramedullary abscesses in children is at times complex, and although many infections can be treated non-surgically with antibiotic therapy, some more extensive infections require surgical management. A timely diagnosis is important as it allows the initiation of the appropriate antimicrobial therapy and would decrease the complexity of the subsequent surgical intervention.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

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The Diagnosis and Management of Pediatric Spine Infections

Saleh

Vasileff

Omari

et al. 2021

Cureus

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“…Її точна частота в дітей до цього часу не відома через невелику кількість повідомлень, доступних у літературі. При ручному пошуку та в базі даних PubMED знайдено лише десять описаних випадків [6,13,14,24,25,29,33,36,51]. ГО атласу складно діагностувати клінічно, оскільки його ознаки, фізикальне обстеження та лабораторні результати можуть бути оманливими, мінливими й неспецифічними.…”

Section: обговоренняunclassified

Torticollis in a 7-year-old child: an alarming sign not to be turned away

Salokha¹,

Borys²

2021

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Acquired torticollis is not a separate disease rather a warning sign of an underlying disorder. The etiology of torticollis in children is quite wide. Hematogenous osteomyelitis of the first cervical vertebra (the atlas) is an extremely rare and potentially dangerous pathology. The aim is to acquaint physicians of different specialties with an extremely rare condition – acute hematogenous osteomyelitis of the atlas. Case Report. A case of osteomyelitis of the first cervical vertebra in a 7-year-old boy is presented. An important sign of the disease is torticollis. Conclusions. Hematogenous osteomyelitis of the atlas is an extremely rare and potentially dangerous pathology. Regardless of its incidence, it must be considered when examining a child with acquired wryneck. All the ENT specialists must possess the knowledge of this disease, as they are most likely the first doctors to see such a child. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: torticollis, osteomyelitis of the atlas, C1 osteomyelitis, vertebral osteomyelitis, children.

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“…Halo immobilization and instrumentation were contraindicated due to the infant's age. 9,10 Orthosis designs using thermoplastic molded braces and Minerva orthoses have been described as safe alternatives to halo immobilization in young children, although they do carry the risk of skin breakdown. 6,11 To ensure best fit of an external device, the device should be custom molded to the patient.…”

mentioning

confidence: 99%

Use of 3D Printing Technology for Cervical Thoracic Lumbosacral Orthosis Fabrication

et al. 2021

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Introduction: This case report describes orthotic design using computed tomography and three-dimensional printing technology combined with traditional orthotic modalities in a newborn patient with chondrodysplasia punctata and cervical spinal stenosis. At day 5 of life, the infant was referred for fitting with a prefabricated cervical collar. Because of the infant's unique stature and small size, traditional prefabricated devices could not be used. The spinal instability and critical nature of the infant prevented traditional methods of orthosis fabrication. A multidisciplinary team used imaging, 3D printing technology, and traditional orthosis fabrication methods to construct a cervical thoracic lumbosacral orthosis (CTLSO). Materials and Methods: Using computed tomography scans, data-segmenting software, and a 3D printer, a life-sized model of the patient's upper body was constructed. Traditional plaster molding and high-temperature orthoplastic techniques were used to fabricate a custom cervical thoracic lumbosacral orthosis for spinal stabilization, necessary for safe patient transport and handling. Results: The custom orthosis demonstrated proper fit and stability, as evidenced by postfitting scans. With orthosis in place, needed care could be provided to the patient more safely and efficiently. In addition, the infant could be held by the caregivers, increasing parental/infant bonding. Conclusions: Technological advances, including the ability to use computer tomography scans in combination with three-dimensional printers, can be a safe and effective option in situations of difficult orthosis fabrication for medically fragile patients. (J Prosthet Orthot. 2022;34:e50-e54)

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Neonatal C1 to C2 Osteomyelitis Leading to Instability and Neurological Decline

Abstract: Level V.

Cited by 10 publications

References 33 publications

The Diagnosis and Management of Pediatric Spine Infections

The Diagnosis and Management of Pediatric Spine Infections

Torticollis in a 7-year-old child: an alarming sign not to be turned away

Use of 3D Printing Technology for Cervical Thoracic Lumbosacral Orthosis Fabrication

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