Spondylodiscitis in neonates

Spondylodiscitis in neonates: A condition which can lead to major spinal complications and potential mortality by Felix Tomé ( Traumatologist ) 

We report a neonate aged 8 weeks who developed severe thoracic spondylodiscitis following pneumonia and septicaemia. Delay in diagnosis caused significant morbidity and resulted in complete destruction of the T4, T5 vertebral bodies and adjacent discs with an associated paraspinal abscess extending into the mediastinum and epidural space. Antibiotic therapy controlled the infection and the abscess was drained through aspiration. At age 6 months, only small reconstritution of the affected vertebrae had occurred and the patient underwent a localized posterior spinal arthrodesis in situ in order to stabilize the thoracic spine and prevent increasing kyphosis. At age 13 months, repeat imaging showed lack of anterior vertebral body re-growth with potential segmental instability and risk for kyphosis progression due to attenuation of the posterior fusion mass. An anterior spinal arthrodesis T3-T6 was performed using rib strut grafts and this prevented deterioration of the kyphosis. At age 5 years, our patient had normal function and no complaints of his back with radiographic evidence of bony fusion across the levels of the spondylodiscitis. Spondylodiscitis should be included in the differential diagnosis of infants who present with atypical symptoms indicating major illness. Misdiagnosis can result in catastrophic spinal complications and a potentially fatal course.

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