Steinlin M, Eich G, Huisman T, Boltshauser E
Universitätskinderklinik Zürich.
Schweiz Med Wochenschr. 1996 Aug 6;126(31-32):1358-64.
Back pain in children is a rare but serious problem. The varied etiologies and the necessary diagnostic workup are illustrated in 8 children. Infectious processes were found in 3 children, spondylodiscitis twice and epidural abscess once. Tumours (one eosinophilic granuloma and one spinal ependymoma) were present in 2 boys. One girl had a herniated lumbar disc. Malformations (spondylolysis and diastematomyelia) were the cause of symptoms in 2 children. Leading symptom in all 8 children was back pain lasting from 3 days to 2 years. Careful clinical neurological examination, parameters of inflammation in the blood and conventional radiography of the spine were helpful in guiding further investigations. Scintigraphy was useful for localization of infectious and tumorous diseases. MRI was superior to CT in evaluating tumours and malformations of the spinal cord. In most cases CT was sufficient in workup of infectious and osseous processes.
儿童背痛是一个罕见但严重的问题。8名儿童展示了其病因的多样性以及必要的诊断检查过程。3名儿童发现有感染性病变,其中2例为脊椎椎间盘炎,1例为硬膜外脓肿。2名男孩患有肿瘤(1例嗜酸性肉芽肿和1例脊髓室管膜瘤)。1名女孩患有腰椎间盘突出症。畸形(椎弓峡部裂和脊髓纵裂)是2名儿童症状的病因。所有8名儿童的主要症状都是背痛,持续时间从3天到2年不等。仔细的临床神经学检查、血液炎症参数和脊柱常规放射照相有助于指导进一步的检查。闪烁扫描术对感染性和肿瘤性疾病的定位很有用。在评估脊髓肿瘤和畸形方面,磁共振成像(MRI)优于计算机断层扫描(CT)。在大多数情况下,CT足以对感染性和骨质病变进行检查。