Schmit P, Fauré C, Denarnaud L
J Radiol. 1985 May;66(5):339-44.
It is not unusual for intervertebral disk calcifications to be detected in pediatric practice, the 150 or so cases reported in the literature probably representing only a small proportion of lesions actually diagnosed. Case reports of 33 children with intervertebral disk calcifications were analyzed. In the majority of these patients (31 of 33) a diagnosis of "idiopathic" calcifications had been made, the cervical localization of the lesions being related to repeated ORL infections and/or trauma. A pre-existing pathologic factor was found in two cases (one child with juvenile rheumatoid arthritis treated by corticoids and one child with Williams and Van Beuren's syndrome). An uncomplicated course was noted in 31 cases, the symptomatology (pain, spinal stiffness and febricula) improving after several days. Complications developed in two cases: one child had very disabling dysphagia due to an anteriorly protruding cervical herniated disc and surgery was necessary; the other child developed cervicobrachial neuralgia due to herniated disc protrusion into the cervical spinal canal, but symptoms regressed within several days although calcifications persisted unaltered. These findings and the course of the rare complications documented in the literature suggest the need for the most conservative treatment possible in cases of disc calcifications in children.
在儿科临床实践中发现椎间盘钙化并不罕见,文献报道的约150例病例可能仅占实际诊断病变的一小部分。对33例患有椎间盘钙化的儿童病例报告进行了分析。在这些患者中的大多数(33例中的31例)被诊断为“特发性”钙化,病变的颈椎定位与反复的耳鼻喉感染和/或创伤有关。在两例患者中发现了先前存在的病理因素(一例患有幼年类风湿关节炎且接受皮质类固醇治疗的儿童,另一例患有威廉姆斯和范布伦综合征的儿童)。31例患者病程顺利,症状(疼痛、脊柱僵硬和低热)在数天后有所改善。两例出现并发症:一例儿童因颈椎间盘突出向前突出导致严重吞咽困难,需要进行手术;另一例儿童因椎间盘突出进入颈椎管而出现颈臂神经痛,但尽管钙化未改变,症状在数天内消退。这些发现以及文献中记录的罕见并发症的病程表明,对于儿童椎间盘钙化病例,需要尽可能采取最保守的治疗方法。