Thoracic Spine Deformity Post Tetanus: A Case Report of Tetanus Post Circumcision
Main Article Content
Abstract
Tetanus is caused by clostridium tetani bacteria through skin breach. The tetanus is characterized by tonic contraction and muscle spasm which can cause vertebral fracture in some patients.
we are reporting a young male patient who after ring circumcision technique had tetanus complicated into thoracic vertebral fracture with severe kyphotic deformity and lower limb functional impairment.
The surgical management was performed in two stages: First stage consisted of Shwab 2 osteotomy, pedicle screws and rod fixation with good result for deformity correction.
The second stage of surgery involved left transpedicular T6 and T5 corpectomies (Shwab 3 osteotomy) plus interbody titanium cage fixation which provided good spinal cord decompression.
Tetanus is still a major complication of circumcision, tetanus complication may be devastating
Early surgical deformity correction and spinal cord decompression provide favorable neurological and functional outcome for patients with spine deformity post tetanus. The Patient was able to walk with crutches 3 months post-surgery.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Tetanus.
https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html
II. Louise Thwaites, tetanus epidemiology. uptodate.com. Nov 18, 2021.
III. Kyu HH, Mumford JE, Stanaway JD, Barber RM, Hancock JR, Vos T, Murray CJ, Naghavi M .Mortality from tetanus between 1990 and 2015: findings from the global burden of disease study 2015. BMC Public Health. 2017;17(1):179. Epub 2017 Feb 8.
IV. Woldeamanuel YW, Andemeskel AT, Kyei K, Woldeamanuel MW, Woldeamanuel W S. Case fatality of adult tetanus in Africa: Systematic review and meta-analysis. J Neurol Sci. 2016;368:292. Epub 2016 Jul 14
V. Sigrid de Sousa dos Santos, Soraya Mena Barreto , Yeh-Li Ho. Lethality and osteomuscular and cardiovascular complications in tetanus. Rev Bras Ter Intensiva. 2011; 23(4):434-441
VI. O. Theodore Roberg J.R. Spinal Deformity Following Tetanus and its relation to juvenile kyphosis. Journal of Bone and Joint Surgery,1937; 19: 603-629.
VII. Cornelius C. Compression Fractures of the thoracic vertebrae in patients with tetanus. JAMA. 1959; 170 (4):455 -657
VIII. Davis P.R, Rowland H.A: Vertebral Fractures in West Africans Suffering from tetanus. A Clinical and Osteological Study. J Bone Joint Surg. 1965; 47(1): 61-7)
IX. Nte AR Gabriel-job N. Tetanus with multiple wedge vertebral collapses(8).A case report of 13 years old girl. Niger J Paed 2013; 40 (2): 189 –191).
X. Itzhak Brook. Infectious Complications of Circumcision and Their Prevention.2016 Oct;2(4):453-459. doi: 10.1016/j.euf.2016.01.013. Epub 2016 Feb 19.)
XI. Anthony S. Burns, MD, and John F. Ditunno, MD. Establishing Prognosis and Maximizing Functional Outcomes After Spinal Cord Injury A Review of Current and Future Directions in Rehabilitation Management. SPINE Volume 26, Number 24S, pp S137–S145 ©2001, Lippincott Williams & Wilkins, Inc.)