A2 Vertaisarvioitu katsausartikkeli tieteellisessä lehdessä
Tumors and infections of the growing spine
Tekijät: Jasiewicz Barbara, Helenius Ilkka
Kustantaja: European Paediatric Orthopaedics Society
Julkaisuvuosi: 2023
Journal: Journal of Children's Orthopaedics
Tietokannassa oleva lehden nimi: JOURNAL OF CHILDRENS ORTHOPAEDICS
Vuosikerta: 17
Numero: 6
Aloitussivu: 556
Lopetussivu: 572
ISSN: 1863-2521
eISSN: 1863-2548
DOI: https://doi.org/10.1177/18632521231215857
Verkko-osoite: https://journals.sagepub.com/doi/full/10.1177/18632521231215857
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/182421311
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.
Ladattava julkaisu This is an electronic reprint of the original article. |