Benoit Vibert1, Marco Turati2,3, Pierre-Yves Rabattu4, Marco Bigoni5,6, Ahmad Eid1, Aurélien Courvoisier1. 1. Department of Paediatric Orthopedic Surgery, Hospital Couple Enfants, Grenoble Alpes University, BP 217, 38043, Grenoble Cedex 9, France. 2. Department of Paediatric Orthopedic Surgery, Hospital Couple Enfants, Grenoble Alpes University, BP 217, 38043, Grenoble Cedex 9, France. turati.mrc@gmail.com. 3. Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy. turati.mrc@gmail.com. 4. Pediatric Surgery Unit, Hospital Couple-Enfants, Grenoble Alpes University, Grenoble, France. 5. Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy. 6. Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Abstract
INTRODUCTION: Kyphosis is a frequent problem in children with spina bifida, and this deformity may cause different complications as respiratory insufficiency, bowel dysfunction, and skin ulcers. CASE REPORT: We report on a 13-year-old myelomeningocele male with a lumbar kyphoscoliosis associated to a septic skin ulceration that resulted in an acute sepsis. An X-ray revealed a kyphosis of 110° and a scoliosis of 25° between T9 and L5. The wound and blood cultures showed Staphylococcus aureus colonization, and an appropriate antibiotic therapy was started. An MRI showed a wedged vertebra at T12, a laminae defects from T8 to the sacrum, and a spondylitis at T12-L1. Ulcer resection and kyphectomy from T12 to L3 were performed "en bloc," and the spine was instrumented fromT7 to S1. After the surgery, the kyphosis was corrected to 10°, and the scoliosis was corrected to 0°. At an 18-month follow-up, a solid bony fusion was obtained, and no recurrence of skin ulcer was reported. CONCLUSION: Antibiotherapy associated to one-step "en-bloc" surgical debridement and kyphectomy should be considered as a valid option to eradicate the infection and to correct the spine deformity in kyphosis due to myelomeningocele associated to septic skin ulcer and spondylitis.
INTRODUCTION:Kyphosis is a frequent problem in children with spina bifida, and this deformity may cause different complications as respiratory insufficiency, bowel dysfunction, and skin ulcers. CASE REPORT: We report on a 13-year-old myelomeningocele male with a lumbar kyphoscoliosis associated to a septic skin ulceration that resulted in an acute sepsis. An X-ray revealed a kyphosis of 110° and a scoliosis of 25° between T9 and L5. The wound and blood cultures showed Staphylococcus aureus colonization, and an appropriate antibiotic therapy was started. An MRI showed a wedged vertebra at T12, a laminae defects from T8 to the sacrum, and a spondylitis at T12-L1. Ulcer resection and kyphectomy from T12 to L3 were performed "en bloc," and the spine was instrumented fromT7 to S1. After the surgery, the kyphosis was corrected to 10°, and the scoliosis was corrected to 0°. At an 18-month follow-up, a solid bony fusion was obtained, and no recurrence of skin ulcer was reported. CONCLUSION: Antibiotherapy associated to one-step "en-bloc" surgical debridement and kyphectomy should be considered as a valid option to eradicate the infection and to correct the spine deformity in kyphosis due to myelomeningocele associated to septic skin ulcer and spondylitis.
Authors: Ricardo de Amoreira Gepp; Marco Rolando Sainz Quiroga; Cícero Ricardo Gomes; Hugo José de Araújo Journal: Childs Nerv Syst Date: 2013-01-31 Impact factor: 1.475
Authors: Ryan S Beyer; Austin J Franklin; Matthew J Hatter; Andrew Nguyen; Nolan J Brown; Gaston Camino-Willhuber; Nestor R Davies; Sohaib Hashmi; Michael Oh; Nitin Bhatia; Yu-Po Lee Journal: J Neurosurg Case Lessons Date: 2022-07-25