Odontoid osteomyelitis with atlantoaxial subluxation in an infant

Purpose To report a rare case of odontoid osteomyelitis with atlantoaxial subluxation in a 6-month-old infant. Background Odontoid osteomyelitis with atlantoaxial subluxation is extremely rare in children. Although several cases have been reported, there have been no studies concerning proper surgical drainage and immobilization in this disease. Methods A 6-month-old infant with odontoid osteomyelitis with atlantoaxial subluxation was surgically treated. The patient underwent a 3-month intravenous and oral antibiotic course and the Minerva body jacket cast was used for 3 months. Follow-up was carried out with computed tomographic scans and a cervical spine dynamogram. Results At 18 months post-surgery, the patient had completely recovered with no cervical instability. Computed tomographic scans revealed complete fusion of odontoid synchondrosis. The infant remained asymptomatic with a full range of head movement. Conclusion Surgical drainage and proper immobilization appears to be a satisfactory treatment for pyogenic osteomyelitis of odontoid synchondrosis secondary to retropharyngeal abscess and atlantoaxial subluxation. Level of evidence N/A.