A2 Vertaisarvioitu katsausartikkeli tieteellisessä lehdessä

Tumors and infections of the growing spine




TekijätJasiewicz Barbara, Helenius Ilkka

KustantajaEuropean Paediatric Orthopaedics Society

Julkaisuvuosi2023

JournalJournal of Children's Orthopaedics

Tietokannassa oleva lehden nimiJOURNAL OF CHILDRENS ORTHOPAEDICS

Vuosikerta17

Numero6

Aloitussivu556

Lopetussivu572

ISSN1863-2521

eISSN1863-2548

DOIhttps://doi.org/10.1177/18632521231215857

Verkko-osoitehttps://journals.sagepub.com/doi/full/10.1177/18632521231215857

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/182421311


Tiivistelmä

The growing spine differs from the adult spine in several ways. Although tumors and infections cause only a small percentage of pediatric back pain incidences, delayed proper diagnosis and treatment may be disastrous. Benign lesions, such as osteoid osteoma, osteoblastoma, and aneurysmal bone cyst in the spine, are predominant during the first two decades of life, whereas malignant bony spinal tumors are rare. In the pediatric population, malignant spine tumors include osteosarcoma, Ewing’s sarcoma, lymphoma, and metastatic neuroblastoma. Infections of the growing spine are rare, with the incidence of discitis peaking in patients under the age of 5 years and that of vertebral osteomyelitis peaking in older children. Spondylodiscitis is often a benign, self-limiting condition with low potential for bone destruction. Conservative treatments, including bedrest, immobilization, and antibiotics, are usually sufficient. Spinal tuberculosis is a frequently observed form of skeletal tuberculosis, especially in developing countries. Indications for surgical treatment include neurologic deficit, spinal instability, progressive kyphosis, late-onset paraplegia, and advanced disease unresponsive to nonoperative treatment. Spinal tumors and infections should be considered potential diagnoses in cases with spinal pain unrelated to the child’s activity, accompanied by fever, malaise, and weight loss. In spinal tumors, early diagnosis, fast and adequate multidisciplinary management, appropriate en bloc resection, and reconstruction improve local control, survival, and quality of life. Pyogenic, hematogenous spondylodiscitis is the most common spinal infection; however, tuberculosis-induced spondylodiscitis should also be considered.


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Last updated on 2024-26-11 at 22:14