Children's Hospital of Philadelphia, Philadelphia, PA.
Children's Specialty Group PLLC, Norfolk, VA.
Pediatr Rev. 2020 Nov;41(11):557-569. doi: 10.1542/pir.2019-0051.
Back pain has long been considered an uncommon complaint in the pediatric population. When present, teaching had been that pediatric back pain almost always has a diagnosable cause, many of which are progressive and potentially debilitating. Recent evidence has suggested that pediatric back pain is not only more common than once thought but also, within certain populations, benign and idiopathic. This, in turn, places an increasing amount of pressure on pediatricians to accurately assess and manage their patients presenting with complaints of back pain. The aim of this article is to serve as a review of the current literature on pediatric back pain. The article reviews the epidemiology, basic anatomy, and important elements of a history and examination, which should be considered when a child presents complaining of back pain. Last, a common differential diagnosis with evaluation and management is also given to help guide pediatricians through their medical decision making.
背痛在儿科人群中一直被认为是一种不常见的主诉。既往认为，即便出现背痛，其也几乎总是有明确的病因，其中许多病因是进行性的，且可能导致残疾。最近的证据表明，儿科背痛不仅比以往认为的更为常见，而且在某些人群中是良性和特发性的。这反过来又给儿科医生带来了越来越大的压力，需要准确评估和管理出现背痛主诉的患者。本文旨在对儿科背痛的现有文献进行综述。文章回顾了儿科背痛的流行病学、基本解剖结构以及病史和体格检查的重要内容，当儿童出现背痛时应考虑这些内容。最后，还给出了常见的鉴别诊断、评估和管理方法，以帮助儿科医生做出医疗决策。
