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Odontoid osteomyelitis with atlantoaxial subluxation in an infant
Hoon Park1, Hyung Kwon Byeon2, Hak-Sun Kim1
1Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea.
Insights
This study details a rare case of odontoid osteomyelitis with atlantoaxial subluxation in an infant. Surgical intervention and immobilization led to complete recovery and fusion, demonstrating an effective treatment approach for this pediatric condition.
Area of Science:
- Pediatric Orthopedics
- Infectious Disease Management
- Spinal Surgery
Background:
- Odontoid osteomyelitis with atlantoaxial subluxation is an exceptionally rare pediatric condition.
- Limited research exists on optimal surgical drainage and immobilization strategies for this specific disease in children.
Observation:
- A 6-month-old infant presented with odontoid osteomyelitis and atlantoaxial subluxation.
- The infant underwent surgical treatment, including a 3-month course of intravenous and oral antibiotics.
- Immobilization was achieved using a Minerva body jacket cast for 3 months, with follow-up via CT scans and cervical spine dynamograms.
Findings:
- At 18 months post-surgery, the patient exhibited complete recovery without cervical instability.
- Computed tomography confirmed complete fusion of the odontoid synchondrosis.
- The infant maintained full range of head motion and remained asymptomatic.
Implications:
- Surgical drainage combined with appropriate immobilization is an effective treatment for pyogenic osteomyelitis of the odontoid synchondrosis causing atlantoaxial subluxation.
- This approach ensures satisfactory outcomes, including spinal stability and functional recovery in pediatric patients.
- Highlights the importance of timely surgical intervention for rare spinal infections in infants.
Purpose:
To report a rare case of odontoid osteomyelitis with atlantoaxial subluxation in a 6-month-old infant.
Background:
Odontoid osteomyelitis with atlantoaxial subluxation is extremely rare in children. Although several cases have been reported, there have been no studies concerning proper surgical drainage and immobilization in this disease.
Methods:
A 6-month-old infant with odontoid osteomyelitis with atlantoaxial subluxation was surgically treated. The patient underwent a 3-month intravenous and oral antibiotic course and the Minerva body jacket cast was used for 3 months. Follow-up was carried out with computed tomographic scans and a cervical spine dynamogram.
Results:
At 18 months post-surgery, the patient had completely recovered with no cervical instability. Computed tomographic scans revealed complete fusion of odontoid synchondrosis. The infant remained asymptomatic with a full range of head movement.
Conclusion:
Surgical drainage and proper immobilization appears to be a satisfactory treatment for pyogenic osteomyelitis of odontoid synchondrosis secondary to retropharyngeal abscess and atlantoaxial subluxation.
Level Of Evidence:
N/A.
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