Boćkowski L, Sobaniec W, Kułak W, Smigielska-Kuzia J, Sendrowski K, Roszkowska M
Department of Pediatric Neurology and Rehabilitation, Medical University of Białystok, Poland.
Adv Med Sci. 2007;52 Suppl 1:221-3.
Low back pain (LBP) is common in adult population, and it is becoming a serious health concern in adolescents. On surveys, about every fifth child in the school-age reports LBP. The study objective was to analysis the natural history, risk factors, clinical symptoms, causes and diagnostic management in school-age children hospitalized with LBP.
The study group consisted of 36 patients at the age between 10 and 18 years, 22 girls and 14 boys suffering from LBP hospitalized in our Department of Pediatric Neurology and Rehabilitation in years 2000-2004.
The mean age of clinical onset of LBP in our group was 14.7 years, earlier in girls, later in boys. We find the family history of LBP in 50% children. Most frequent factors associated with LBP were: spina bifida (16.7%) and incorrect posture (13.9%). Half of patients pointed the factor initialising LBP: rapid, incoordinated move (39%) or heavy load rise (11%). 58% of patients present the symptoms of ischialgia. Diagnostic imaging showed disc protrusion in 11 children (31%) 6 in computed tomography, 4 in magnetic resonance imaging and 1 in X-Ray examination only. Other causes of LBP included: spondylolysis in 2 patients, Scheuermann disease in one case and juvenile reumatoid arthritis in one case.
Some school-age children suffering on low back pain, particulary with sciatic neuralgia symptoms seek medical care in hospital. Althought the main causes are mechanical, associated with lack of physical activity or strenous exercise, serious diagnostic managment is strongly recommended.
下背痛（LBP）在成年人群中很常见，在青少年中也日益成为严重的健康问题。据调查，学龄儿童中约每五个就有一个报告有下背痛。本研究的目的是分析因下背痛住院的学龄儿童的自然病史、危险因素、临床症状、病因及诊断处理。
研究组由2000年至2004年在我院小儿神经科及康复科住院的36例10至18岁的下背痛患者组成，其中女孩22例，男孩14例。
我们组下背痛临床发病的平均年龄为14.7岁，女孩发病较早，男孩较晚。我们发现50%的儿童有下背痛家族史。与下背痛相关的最常见因素是：脊柱裂（16.7%）和姿势不正确（13.9%）。一半的患者指出了引发下背痛的因素：快速、不协调的动作（39%）或重物提起（11%）。58%的患者有坐骨神经痛症状。诊断性影像学检查显示11名儿童（31%）有椎间盘突出，其中6例在计算机断层扫描中发现，4例在磁共振成像中发现，1例仅在X线检查中发现。下背痛的其他病因包括：2例椎弓峡部裂，1例休门病，1例幼年类风湿关节炎。
一些患有下背痛，尤其是伴有坐骨神经痛症状的学龄儿童会到医院就医。虽然主要病因是机械性的，与缺乏体育活动或剧烈运动有关，但强烈建议进行认真的诊断处理。
