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[Kyphosis caused by severe spondylodiscitis in newborn infants and young children]
Insights
Pyogenic discitis in newborns and children can lead to Pott's disease and severe kyphosis. Surgical intervention, including anterior and posterior arthrodesis with corrective osteotomy, is the recommended treatment for spinal deformities.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Spinal Surgery
Background:
- Discitis, an infection of the intervertebral disc space, can affect newborns and young children.
- Pyogenic infections, often associated with septicemia, are common in neonatal discitis.
- Pott's disease, a form of tuberculous or pyogenic spondylitis, can develop later.
Observation:
- The study reviewed 12 cases of discitis in newborns and young children.
- Clinical examination revealed severe kyphosis resulting from anterior vertebral destruction.
- Conservative immobilization during growth did not prevent deformity progression or potential neurological complications.
Findings:
- Pyogenic infections in newborns presented with general septicemia.
- Pott's disease onset was later, characterized by significant kyphosis due to vertebral destruction.
- Conservative management failed to halt kyphosis progression before puberty.
Implications:
- Early surgical intervention is crucial for managing discitis-induced spinal deformities.
- Combined anterior arthrodesis, corrective osteotomy, and posterior arthrodesis offer the best treatment outcomes.
- Delayed presentation necessitates careful evaluation of kyphosis severity and neurological status for surgical planning.
Abstract:
The authors report their experience of 12 discitis occurring in the new born and in young children. Pyogenic infections were found with general septicemia in the new born children. The onset of cases of Pott's disease occurred later. Anterior destruction of several vertebrae accounted for severe kyphosis which were found on clinical examination. Conservative immobilisation of the kyphosis during growth does not prevent any increase in deformity before puberty with the possible onset of neurological symptoms. The only possible treatment is surgical with anterior arthrodesis of the damaged region together with a corrective osteotomy followed as soon as possible by posterior arthrodesis. If, unfortunately the patient is seen later in the course of the disease, the possibility of corrective osteotomy will depend on the degree of kyphosis and the neurological symptoms.