University Hospital Leipzig, Department of Pediatric Radiology, Liebigstr. 20a, 04103 Leipzig, Germany.
J Pediatr Surg. 2010 Aug;45(8):1737-40. doi: 10.1016/j.jpedsurg.2010.04.010.
Vertebral infection represents 2% to 4% of all cases of osteomyelitis in children. Extension of vertebral osteomyelitis into the vertebral arch is rare; and exclusive pyogenic involvement is exceedingly rare, especially in children. A review of the literature revealed less than 25 combined cases, most of them reported in the beginning of the 20th century without cross-sectional imaging. The unusual location creates difficulties in distinguishing vertebral osteomyelitis from neoplasm and arthritic conditions. We present 2 cases of infection of the posterior vertebral elements. Most useful in identifying the presence and extent of infection were a sudden onset of nonspecific back pain, elevated inflammatory parameters, and magnetic resonance imaging. Antibiotic therapy with or without surgical intervention provided successful management. With the recurrence observed in 1 child, the most optimal treatment of this condition might still be unknown.
脊柱感染占儿童骨髓炎的 2%至 4%。椎骨骨髓炎扩展到椎弓的情况很少见；单纯化脓性感染极其罕见，尤其是在儿童中。对文献的回顾发现，不到 25 例联合病例，其中大多数在 20 世纪初报告，没有横断面成像。异常位置增加了与肿瘤和关节炎疾病区分椎骨骨髓炎的难度。我们介绍了 2 例后椎体元素感染的病例。最有助于识别感染存在和程度的是突发性非特异性背痛、炎症参数升高和磁共振成像。抗生素治疗联合或不联合手术干预均提供了成功的治疗效果。1 例患儿出现复发，这种情况下可能仍需要进一步探索最佳治疗方案。
