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Surgical treatment of spondylitis and diaphragm relaxation in patient less than 1 year old
- St-Petersburg Science-Research Institute of Phthisiopulmonology, St-Petesburg, Russian Federation
- St-Petersburg North-West State Medical University named by I.I. Mechnikov, St-Petesburg, Russian Federation
- St-Petersburg State University, St-Petesburg, Russian Federation
open access
Abstract
Case report.
IntroductionThe combination of severe post-infectious kyphosis and diaphragm relaxation is extremely rare in patient early than 1 year old. Its no publications concerning their simultaneous surgical treatment.
Case description7-Month-old girl had simultaneous spinal reconstruction with anterior and posterior instrumentation and plastic of diaphragm because of sequelae of non-granulenatous spondylitis complicated by severe kyphosis (54°) and diaphragm relaxation. Between 1.5 and 3 months of live she had several infections incl. pneumonia, enterocolitis, ENT infection. Anterior fusion was done by titanium mesh with auto-rib, posterior – by compressive rods based on low-profile hooks. The deformity was reduced till 20°. 2.5 years after initial surgery and 1 year after removal of posterior instrumentation the adequate level of diaphragm and minimal (4°) loss of kyphosis correction were identified.
ConclusionsThe combination of spondylitis and diaphragm relaxation in early aged patient could be explained but it could not be confirmed as a sequelae of late-onset neonatal sepsis with a multi-focal lesions. The simultaneous surgery provided on the combined approaches (trans-thoracic and posterior) looks as optimal options in such combination of pathologies. In remains controversial how will the spine develop after so early reconstructive surgery, including in situ stable anterior fusion carried out by titanium mesh with auto-rib.
Abstract
Case report.
IntroductionThe combination of severe post-infectious kyphosis and diaphragm relaxation is extremely rare in patient early than 1 year old. Its no publications concerning their simultaneous surgical treatment.
Case description7-Month-old girl had simultaneous spinal reconstruction with anterior and posterior instrumentation and plastic of diaphragm because of sequelae of non-granulenatous spondylitis complicated by severe kyphosis (54°) and diaphragm relaxation. Between 1.5 and 3 months of live she had several infections incl. pneumonia, enterocolitis, ENT infection. Anterior fusion was done by titanium mesh with auto-rib, posterior – by compressive rods based on low-profile hooks. The deformity was reduced till 20°. 2.5 years after initial surgery and 1 year after removal of posterior instrumentation the adequate level of diaphragm and minimal (4°) loss of kyphosis correction were identified.
ConclusionsThe combination of spondylitis and diaphragm relaxation in early aged patient could be explained but it could not be confirmed as a sequelae of late-onset neonatal sepsis with a multi-focal lesions. The simultaneous surgery provided on the combined approaches (trans-thoracic and posterior) looks as optimal options in such combination of pathologies. In remains controversial how will the spine develop after so early reconstructive surgery, including in situ stable anterior fusion carried out by titanium mesh with auto-rib.
Keywords
Spondylitis, Diaphragm relaxation, Neonatal sepsis, Titanium mesh, Pediatric spine surgery
Title
Surgical treatment of spondylitis and diaphragm relaxation in patient less than 1 year old
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
374-378
Page views
282
Article views/downloads
331
DOI
10.1016/j.pjnns.2016.05.003
Bibliographic record
Neurol Neurochir Pol 2016;50(5):374-378.
Keywords
Spondylitis
Diaphragm relaxation
Neonatal sepsis
Titanium mesh
Pediatric spine surgery
Authors
A.Y. Mushkin
E.Y. Malyarova
V.A. Evseev
P.K. Yablonskii