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Congenital lumbar kyphosis with skin ulceration and osteomyelitis in a myelomeningocele child: a case report

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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.

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Authors and Affiliations

  1. Department of Paediatric Orthopedic Surgery, Hospital Couple Enfants, Grenoble Alpes University, BP 217, 38043, Grenoble Cedex 9, France

    Benoit Vibert, Marco Turati, Ahmad Eid & Aurélien Courvoisier

  2. Orthopedic Department, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy

    Marco Turati & Marco Bigoni

  3. Pediatric Surgery Unit, Hospital Couple-Enfants, Grenoble Alpes University, Grenoble, France

    Pierre-Yves Rabattu

  4. Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

    Marco Bigoni

Authors
  1. Benoit Vibert
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  2. Marco Turati
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  3. Pierre-Yves Rabattu
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  4. Marco Bigoni
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  5. Ahmad Eid
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  6. Aurélien Courvoisier
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Corresponding author

Correspondence to Marco Turati.

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The authors declare that they have no competing interest.

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Vibert, B., Turati, M., Rabattu, PY. et al. Congenital lumbar kyphosis with skin ulceration and osteomyelitis in a myelomeningocele child: a case report. Childs Nerv Syst 34, 771–775 (2018). https://doi.org/10.1007/s00381-017-3598-4

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  • DOI: https://doi.org/10.1007/s00381-017-3598-4

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