Division of Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Queen's University, School of Medicine, Kingston, Ontario, Canada.
Division of Neurosurgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Neurosurgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
J Pediatr. 2019 Mar;206:212-216. doi: 10.1016/j.jpeds.2018.10.058. Epub 2018 Nov 19.
To review pediatric idiopathic intervertebral disc calcification (PIIVDC) within a single center and within the literature to outline the disease course, management, and outcome.
A retrospective chart review was performed spanning the period between January 2001 and February 2016 for diagnoses of PIIVDC. Patient age, sex, symptoms, and history and physical and neurologic findings were reviewed. Laboratory and imaging findings, management, follow-up, and outcome also were studied.
Nine cases of PIIVDC were identified; they included 6 male and 3 female patients, with an age range of 23 months to 12 years. Two patients were asymptomatic, and PIIVDC was discovered incidentally. Of the remaining 7 patients, 5 presented with neck and/or back pain, 1 with painless torticollis, and 1 with painful torticollis. One patient reported neurologic symptoms of pain radiating along 1 dermatome. Disc spaces affected were 5 cervical, 4 thoracic, and 2 lumbar, with 2 patients having more than 1 space affected. All patients were managed conservatively. In 1 case, symptoms and lesions persisted after 5 years, but the remainder had complete symptom resolution, generally within 6 months.
The etiology of PIIVDC remains unknown but appears to occur spontaneously, without preceding trauma or underlying medical condition. A conservative approach to patients without severe neurologic deficit with outpatient follow-up is supported.
在单一中心内并结合文献回顾小儿特发性椎间盘钙化(PIIVDC),以阐明其病程、治疗和结局。
对 2001 年 1 月至 2016 年 2 月期间诊断为 PIIVDC 的患者进行回顾性图表审查。回顾了患者的年龄、性别、症状、病史以及体格检查和神经系统检查结果。研究了实验室和影像学发现、治疗、随访和结局。
共发现 9 例 PIIVDC,包括 6 例男性和 3 例女性,年龄 23 个月至 12 岁。2 例患者无症状,PIIVDC 为偶然发现。其余 7 例患者中,5 例表现为颈背部疼痛,1 例表现为无痛性斜颈,1 例表现为疼痛性斜颈。1 例患者报告了沿 1 个皮节放射的疼痛性神经症状。受累椎间盘间隙为 5 个颈椎、4 个胸椎和 2 个腰椎,2 例患者有 1 个以上间隙受累。所有患者均采用保守治疗。1 例患者在 5 年后症状和病变仍持续存在,但其余患者的症状一般在 6 个月内完全缓解。
PIIVDC 的病因尚不清楚,但似乎是自发发生的,无先前创伤或潜在疾病。支持对无严重神经功能缺损的患者采用门诊随访的保守治疗方法。