Neonatal Vertebral Osteomyelitis: Case Report and Literature Review
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Published:
Feb 24, 2025
Keywords:
Neonatal, vertebral osteomyelitis, pyogenic spondylodiscitis, infant
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Abstract
Neonatal vertebral osteomyelitis is a severe and extremely rare condition that is challenging to treat and rarely requires open surgery during the acute phase. We present a case of a 25-day-old neonate who was admitted to the Neonatal Intensive Care Unit due to a respiratory infection with poor progression and no response to conventional treatment. The patient subsequently developed lower cervical and upper thoracic spondylodiscitis, with progressive deterioration and worsening general condition. Open surgicaldebridement and anterior reconstruction were performed, along with prolonged sequential antibiotic therapy (intravenous to oral). In selected cases, neonatal vertebral osteomyelitis may require open surgical treatment for the resolution of acute infection. However, this approach does not eliminate the risk of residual deformities.
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How to Cite
Manzone, P., & Ovejero, M. P. (2025). Neonatal Vertebral Osteomyelitis: Case Report and Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 90(1), 80-89. https://doi.org/10.15417/issn.1852-7434.2025.90.1.2037
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Case Presentations
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pacientes menores de 10 años. Rev Asoc Argent Ortop Traumatol 2017;82(3):220-30. https://doi.org/10.15417/616
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treatment for advanced thoracic spinal tuberculosis in infants: case series and literature review. Int J Spine Surg
2022;16(2):393-403. https://doi.org/10.14444/8220
23. Eismont F, Bohlman H, Soni P, Goldberg V, Freehafer A. Vertebral osteomyelitis in infants. J Bone Joint Surg Br
1982;64-B(1):32-5. https://doi.org/10.1302/0301-620X.64B1.7068717
24. Rajasekaran S. Natural history of Pott’s kyphosis. Eur Spine J 2013;22(Suppl 4):634-40.
https://doi.org/10.1007/s00586-012-2336-6
25. Zhang Z. Late onset Pott’s paraplegia in patients with upper thoracic sharp kyphosis. Int Orthop 2012;36(2):381-5. https://doi.org/10.1007/s00264-011-1285-8
2. Sharma RR, Sethu AU, Mahapatra AK, Pawar SJ, Nath A. Neonatal cervical osteomyelitis with paraspinal abscess and Erb’s Palsy: A case report and brief review of the literature. Pediatr Neurosurg 2000;32(5):230-3.
https://doi.org/10.1159/000028943
3. Glotzbecker MP, Wasser AM, Troy MJ, Proctor M, Emans JB. Neonatal C1 to C2 osteomielitis leading to instability and neurological decline: Novel treatment with occiput-C1-C2 fusion and occiput to thorax growing rods. A case report. J Pediatr Orthop 2015;35(4):379-84. https://doi.org/10.1097/BPO.0000000000000309
4. Berberian G, Firpo V, Soto A, Lopez Mañan J, Torroija C, Castro G et al. Osteoarthritis in the neonate: risk factors and outcome. Braz J Infect Dis 2010;14(4):413-8. https://doi.org/10.1590/S1413-86702010000400018
5. Coto Cotallo GD, Solís Sánchez G, Crespo Hernández M, Ramos Aparicio A, Bousoño García C, Orejas R-Arango
G. Neonatal osteomyelitis. Study of a series of 35 cases. An Esp Pediatr 1990;33(5):429-34. PMID: 2096756
6. Kiechl-Kohlendorfer U, Griesmaier E. Neonatal osteomyelitis. En: Resch B (ed). Neonatal bacterial infection.
Rijeka, Croatia: InTech; 2013. https://doi.org/10.5772/54320
7. Ogden JA. Pediatric osteomyelitis and septic arthritis: the pathology of neonatal disease. Yale J Biol Med 1979;52(5):423. PMID: 524924
8. Mutlu M, Selim D, Yakup A. Deep neck abscess in neonatal period: case report and review of literature. Int J
Pediatr Otorhinolaryngol 2014;78(4):577-82. https://doi.org/10.1016/j.ijporl.2014.01.015
9. Mishra A, Yadav PK, Mishra A, Mallick AK. Retropharyngeal abscess presenting as stridor in a 35 days male infant: A case report. Asian J Pediatr Res 2022;8(3):10-4. https://doi.org/10.9734/ajpr/2022/v8i330243
10. Munhoz Da Rocha LE, Conrad S, Abreu de Aguiar C, Müller Ávila L. Paper 159: Neonatal spondylodiscitis: Case
series and literature review. 22nd IMAST, July 8-11, 2015, Kuala Lumpur, Malaysia; p. 173.
11. Wong M, Isaacs D, Howman-Giles R, Uren R. Clinical and diagnostic features of osteomyelitis occurring in the first three months of life. Pediatr Infect Dis J 1995;14(12):1047-53. https://doi.org/10.1097/00006454-199512000-00004
12. Offiah AC. Acute osteomyelitis, septic arthritis and discitis: differences between neonates and older children. Eur J Radiol 2006;60(2):221-32. https://doi.org/10.1016/j.ejrad.2006.07.016
13. Decembrino L, Decembrino N, Stronati M, Barria RM. Neonatal osteomyelitis. En: Barría RM (ed.). Selected topics in neonatal care. Rijeka, Croatia: InTech; 2018, p. 97-107. https://doi.org/10.5772/65564
14. Villalobos AF, Sanz Marcos N, Ventura Gómez N, García García JJ. Osteomielitis vertebral neonatal con afectación discal. An Pediatr (Barc) 2010;73(6):368-9. https://doi.org/10.1016/j.anpedi.2010.08.002
15. Ben-Meir E, Rubinshtein M, Pessach I, Barkai G, Keller N, Hoffman C, et al. Neonatal cervical osteomyelitis with bilateral upper limb paresis. Pediatr Infect Dis J 2017;36(10):1013-5. https://doi.org/10.1097/INF.0000000000001618
16. van Dalen IV, Heeg M. Neonatal infectious spondylitis of the cervical spine presenting with quadriplegia: A case report. Spine (Phila PA 1976) 2000;25(11):1450-2. https://doi.org/10.1097/00007632-200006010-00019
17. Tomaszewski R, Bijata W. Acute haematogenous upper cervical osteomyelitis in neonates: a report of two cases. J Bone Joint Surg Br 2011;93(6):849-52. https://doi.org/10.1302/0301-620X.93B6.25857
18. Tsirikos AI, Tome-Bermejo F. Spondylodiscitis in infancy. J Bone Joint Surg Br 2012;94(10):1399-1402.
https://doi.org/10.1302/0301-620X.94B10.29602
19. Romano S, Vittoria F, Cataruzzi E, Barbi E, Carbone M. Infectious spondylodiscitis and kyphosis correction in an infant: A case report and review of the literature. Ital J Pediatr 2021;47(1):152. https://doi.org/10.1186/s13052-021-01106-4
20. Ecury-Goossen G, Huysman MA, Verhallen-Dantuma JC, Man P. Sequential intravenous-oral antibiotic therapy for neonatal osteomyelitis. Pediatr Infect Dis J 2009;28(1):72-3. https://doi.org/10.1097/INF.0b013e318189a90e
21. Sotomayor HE, Remondino R, Tello C, Galaretto E, Francheri I, Bersusky E, et al. Instrumentación cervical en
pacientes menores de 10 años. Rev Asoc Argent Ortop Traumatol 2017;82(3):220-30. https://doi.org/10.15417/616
22. Egea-Gámez RM, Galán-Olleros M, González-Menocal A, Martínez-González C, González-Díaz R. Surgical
treatment for advanced thoracic spinal tuberculosis in infants: case series and literature review. Int J Spine Surg
2022;16(2):393-403. https://doi.org/10.14444/8220
23. Eismont F, Bohlman H, Soni P, Goldberg V, Freehafer A. Vertebral osteomyelitis in infants. J Bone Joint Surg Br
1982;64-B(1):32-5. https://doi.org/10.1302/0301-620X.64B1.7068717
24. Rajasekaran S. Natural history of Pott’s kyphosis. Eur Spine J 2013;22(Suppl 4):634-40.
https://doi.org/10.1007/s00586-012-2336-6
25. Zhang Z. Late onset Pott’s paraplegia in patients with upper thoracic sharp kyphosis. Int Orthop 2012;36(2):381-5. https://doi.org/10.1007/s00264-011-1285-8