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CASE REPORT
Year : 2020  |  Volume : 15  |  Issue : 2  |  Page : 397-404

Expandable titanium cages in the emergent treatment of severe spinal deformity secondary to osteomyelitis: A series of three complex cases


1 Department of Neurosurgery, Tampa General Hospital, University of South Florida Morsani College of Medicine, Tampa, USA
2 Department of Neurosurgery, Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, Johns Hopkins University School of Medicine, Saint Petersburg, Florida, USA

Correspondence Address:
Dr. Puya Alikhani
Department of Neurosurgery, University of South Florida, Tampa, Florida
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_28_20

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The literature lacks robust evidence on the benefits versus risks of instrumenting and fusing the spinal column in the setting of active osteomyelitis. We report three patients with vertebral osteomyelitis and subsequent severe and complex kyphotic deformities. Patients 1 and 2 had previous instrumentation that required revision because of hardware failure in the thoracic and thoracolumbar regions, respectively. Patient 3 developed a severe cervical kyphotic deformity at 2 months after being diagnosed and treated with antibiotics for osteomyelitis, necessitating emergent instrumentation and fusion. All the three patients are doing very well so far. Spinal instrumentation and fusion for correction of kyphotic deformity is sometimes necessary in the context of active osteomyelitis and should be done emergently and without hesitation when spinal cord injury from spinal instability is of concern.


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