Sułko Jerzy
Oddział Ortopedyczno-Urazowy, Polsko-Amerykański Instytut Pediatrii w Krakowie.
Chir Narzadow Ruchu Ortop Pol. 2011 Jan-Feb;76(1):31-5.
Evaluation of children with intervertebral disc calcification (IDC) and own experience.
A retrospective analysis of 7 patients (2 girls and 5 boys) with detected, in the years 1990-2009, IDC. Age at the onset of symptoms (neck pain in 6 patients, torticollis in 4, hip pain in one) was on average 8.7 years (5-13 years). The diagnosis was based on review of radiographs of the spine, which revealed the presence of calcifications within the intervertebral discs in the cervical (4 patients), cervical and thoracic (2 patients) and thoracic spine (1 patient). The mean level of IDC on average was 3.3 spaces (1-6).
After conservative treatment, including use of nonsteroidal anti-inflammatory drugs and rest, the symptoms subsided within 1-2 weeks. 4 patients had a return of pain in the neck, in one year, but the symptoms were milder and resolved within a few days. The mean observation period was 9 years (3.5-16 years). In 4 patients, changes disappeared completely, while in the remaining three there was a very discrete calcifications. One patient, after 6 years, had a pain in the neck, and CT showed minor lytic changes on the surface of the vertebral bodies between which calcification occurred.
ś IDC is a rare disease of the spine in children, but should be taken into account in cases of vertebral pain. Usually the disease affects children before the age of 10 and locates in the cervical spine. But it can be located in every segment of the spine. Most patients have multilevel location. Acute phase of the disease requires conservative treatment. Rarely used surgical treatment should be considered only in patients with persistant neurological symptoms. The natural course of the disease is mild, and over the years calcification gradually disappear spontaneously.
评估椎间盘钙化(IDC)患儿并分享自身经验。
对1990年至2009年间确诊的7例(2例女孩和5例男孩)IDC患儿进行回顾性分析。症状发作时的年龄(6例颈部疼痛,4例斜颈,1例髋部疼痛)平均为8.7岁(5 - 13岁)。诊断基于脊柱X线片复查,结果显示颈椎(4例)、颈胸椎(2例)和胸椎(1例)椎间盘内存在钙化。IDC平均累及节段数为3.3个(1 - 6个)。
经过包括使用非甾体类抗炎药和休息在内的保守治疗,症状在1 - 2周内消退。4例患儿在1年内颈部疼痛复发,但症状较轻,数天内缓解。平均观察期为9年(3.5 - 16年)。4例患儿的病变完全消失,其余3例仍有非常轻微的钙化。1例患儿在6年后出现颈部疼痛,CT显示钙化所在椎体表面有轻微骨质溶解改变。
IDC是儿童脊柱的一种罕见疾病,但在出现椎体疼痛的病例中应予以考虑。该病通常发生在10岁以下儿童,好发于颈椎,但也可发生于脊柱的任何节段。大多数患者为多节段受累。疾病急性期需要保守治疗。仅在有持续神经症状的患者中才考虑很少使用的手术治疗。该病自然病程较轻,多年来钙化会逐渐自发消失。