Yagdiran Ayla, Meyer-Schwickerath Charlotte, Wolpers Raphael, Otto-Lambertz Christina, Mehler Katrin, Oberthür Andre, Kernich Nikolaus, Eysel Peer, Jung Norma, Zarghooni Kourosh
Department of Orthopedic and Trauma Surgery, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany.
Department I of Internal Medicine, Faculty of Medicine and University Hospital of Cologne, Center for Integrated Oncology, University of Cologne, 50937 Cologne, Germany.
Children (Basel). 2022 Jul 22;9(8):1103. doi: 10.3390/children9081103.
Pediatric spondylodiscitis (PSD) is a rare disease with a major impact on mobility and functional status. Data concerning demographic and microbiological characteristics, clinical course, treatment, and outcome are scarce. Therefore, the aim of this study was to present clinical experiences of a third-level hospital (2009-2019) in PSD and compare these with adult spondylodiscitis (ASD). Of a total of 10 PSD patients, most of the infants presented with unspecific pain such as hip pain or a limping, misleading an adequate diagnosis of spine origin. Eight patients could be treated conservatively whereas surgery was performed in two cases with one case of tuberculous PSD (tPSD). The causative agent was detected in three of the patients. The diagnosis of PSD is often difficult since clinical symptoms are unspecific and causative pathogens often remain undetected. Nevertheless, empirical anti-infective therapy also seems to be effective. Based on recent studies, clinicians should be encouraged to keep the duration of anti-infective therapy in children short. Since comorbidities are not presented in PSD it is unclear which children suffer from PSD; thus, studies are necessary to identify predisposing factors for PSD. In our study, PSD differs from ASD in diagnostic and especially in therapeutic aspects. Therefore, specific guidelines for PSD would be desirable.
小儿脊椎椎间盘炎（PSD）是一种罕见疾病，对活动能力和功能状态有重大影响。关于人口统计学和微生物学特征、临床病程、治疗及预后的数据稀缺。因此，本研究旨在介绍一家三级医院（2009 - 2019年）在小儿脊椎椎间盘炎方面的临床经验，并将其与成人脊椎椎间盘炎（ASD）进行比较。在总共10例小儿脊椎椎间盘炎患者中，大多数婴儿表现为非特异性疼痛，如髋关节疼痛或跛行，导致对脊柱源性疾病的准确诊断产生误导。8例患者可采用保守治疗，2例进行了手术，其中1例为结核性小儿脊椎椎间盘炎（tPSD）。3例患者检测出了病原体。小儿脊椎椎间盘炎的诊断通常很困难，因为临床症状不具特异性，致病病原体常常未被检测到。然而，经验性抗感染治疗似乎也有效。基于最近的研究，应鼓励临床医生缩短儿童抗感染治疗的疗程。由于小儿脊椎椎间盘炎未出现合并症，目前尚不清楚哪些儿童患有此病；因此，有必要开展研究以确定小儿脊椎椎间盘炎的易感因素。在我们的研究中，小儿脊椎椎间盘炎在诊断方面，尤其是治疗方面与成人脊椎椎间盘炎不同。因此，需要制定小儿脊椎椎间盘炎的具体指南。
