Department of Paediatric Orthopaedic Surgery, Ibaraki Children's Hospital (Tsukuba Pediatric Orthopaedic Group), Mito City, Ibaraki, Japan.
Chiba Child and Adult Orthopaedic Clinic (Chiba Pediatric Orthopaedic Group), Chiba City, Chiba, Japan.
Eur Spine J. 2020 Oct;29(10):2465-2469. doi: 10.1007/s00586-020-06553-x. Epub 2020 Jul 31.
We often encounter elementary school-aged children with fresh lumbar spondylolysis and non-union of bone. They may have factors that impede healing, and treatment outcomes need improvement. The purpose of this study was to investigate elementary school-aged patients with fresh lumbar spondylolysis and to identify characteristics that can aid in prompt diagnosis and proper therapy.
We retrospectively compared the characteristics of fresh lumbar spondylolysis in elementary school-aged children with those of older patients. We included patients aged 6-18 years with lower back pain and evidence of bone marrow oedema of lumbar pedicles on magnetic resonance imaging (MRI). The elementary school-aged group (group E) included 100 patients aged 6-12 years, and the senior group (group S) included 251 patients aged 13-18 years. We recorded patient sex, duration of lower back pain, injured site (lumbar level, unilateral/bilateral), presence of contralateral pars defect with evidence of high signal change on MRI (short tau inversion recovery), presence of spina bifida occulta (SBO), and follow-up treatment interruption rate.
One-third of the patients in group E were female, and there was an even smaller proportion of females in group S. L5 lumbar spondylolysis was more common in group E. The treatment interruption rate was lower in group E. L5 SBO and contralateral pars defect were more common in group E.
L5 lumbar spondylolysis, L5 SBO, and contralateral pars defect were important diagnostic factors in elementary school-aged patients. Identification of these characteristics will aid in prompt diagnosis and proper therapy.
我们经常遇到患有新鲜腰椎峡部裂和骨不连的小学生。他们可能存在阻碍愈合的因素，治疗效果需要改善。本研究的目的是研究小学生新鲜腰椎峡部裂，并确定有助于快速诊断和适当治疗的特征。
我们回顾性比较了小学生新鲜腰椎峡部裂的特征，并与年龄较大的患者进行了比较。我们纳入了年龄在 6-18 岁之间、有腰痛和磁共振成像（MRI）显示腰椎椎弓根骨髓水肿证据的患者。小学生组（E 组）包括 100 例 6-12 岁患者，高年级组（S 组）包括 251 例 13-18 岁患者。我们记录了患者的性别、腰痛持续时间、损伤部位（腰椎水平、单侧/双侧）、MRI 上是否存在对侧峡部缺陷并伴有高信号改变（短 tau 反转恢复）、是否存在隐性脊柱裂（SBO）以及随访治疗中断率。
E 组中有三分之一的患者为女性，S 组中女性比例更小。E 组中 L5 腰椎峡部裂更为常见。E 组的治疗中断率较低。E 组中 L5 SBO 和对侧峡部缺陷更为常见。
L5 腰椎峡部裂、L5 SBO 和对侧峡部缺陷是小学生的重要诊断因素。识别这些特征将有助于快速诊断和适当治疗。
