Complications of Therapies for Spine Infections in Children

Surgical

Spine infections in children

• Neurological deficits: Injury to spinal cord from excessive intraoperative manipulation can occur with resulting neurological signs (124).
• Spinal instability: Excessive decompression can cause spinal instability. Over time this can result in spinal deformity (124).
• Hardware or spinal fixation device failure: Instrumentation may fail over time with screws migrating, or rods or plates breaking (124).
• CSF leaks: Leakage of CSF from the wound can occur in the postoperative period if the dura is violated (124).
• Wound reinfections: There can be treatment failure with a reemergence of the infection or the development of a new infection (124).

Spinal epidural abscesses in children

• Neurological deficits: Injury to spinal cord from excessive intraoperative manipulation can occur with resulting neurological signs (55).
• Spinal instability: Excessive decompression can cause spinal instability (55). Over time this can result in spinal deformity.
• CSF leaks: Leakage of CSF from the wound can be seen in the postoperative period (55).
• Wound infections (55).

Spinal subdural abscesses in children

• Neurological deficits: Injury to spinal cord from excessive intraoperative manipulation can occur with resulting neurological deficits.
• Spinal instability: Excessive decompression can cause spinal instability. Over time this can result in spinal deformity.
• CSF leaks: Leakage of CSF from the wound can occur in the postoperative period.
• Wound infections
• Arachnoiditis and tethering of spinal cord: Over time symptoms of arachnoiditis or of a tethered spinal cord can develop.

Intramedullary spinal cord abscesses in children

• Neurological deficits: Neurological deficits are relatively common after surgery for an intramedullary spinal cord abscess. In addition to injury at the time of surgery, such deficits may arise over time from tethering of the spinal cord during growth, mass effect of a concomitant epidermoid or dermoid tumor that grows, or a subsequent infection.
• Recurrent abscess formation: If there has been incomplete removal of the dermoid sinus tract, recurrent abscess formation may occur.

Medical

• Antibiotic complications: The use of long-term antibiotics has been associated with thrombophlebitis, allergies, intolerance, and drug resistance (142, 143).