Spondylodiszitis im Kindes- und Jugendalter

Völker, Anna; Schubert, Stephan; Heyde, Christoph-Eckhard

doi:10.1007/s00132-016-3273-6

Cited by 8 publications

(7 citation statements)

References 35 publications

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“…Even if children are the second age group after elderly patients, only 2%–4% of musculoskeletal infections are in the spine area. 75 The peak of incidence of discitis is in patients below 5 years of age, whereas older children develop more vertebral osteomyelitis. 76 , 77 There are several associated risk factors, including immunocompromised states, direct trauma with hematoma, hematogenous spread (skin, genitourinary tract, oral cavity, respiratory tract, and middle ear), and spine surgery (not included in the review).…”

Section: Infections Of the Spinementioning

confidence: 99%

Tumors and infections of the growing spine

Jasiewicz,

Helenius

2023

Journal of Children's Orthopaedics

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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. Level of evidence: level 4.

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Section: Infections Of the Spinementioning

confidence: 99%

Tumors and infections of the growing spine

Jasiewicz,

Helenius

2023

Journal of Children's Orthopaedics

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“…Ätiologisch kann eine unspezifische, pyogene von einer spezifischen, durch Tuberkulose oder Brucellose bedingten, Spondylodiszitis unterschieden werden [8,12,13]. Sofern ein Erregernachweis der pyogenen Spondylodiszitis gelingt, wird bei Säuglingen bis zum 6.…”

Section: Fallbericht Patientunclassified

“…Andere Erreger der Spondylodiszitis im Kindesalter, die jedoch deutlich seltener nachgewiesen werden, stellen Staphylococcus epidermidis, Koagulase-negative Staphylokokken, alpha-hämolysierende Streptokokken, Streptococcus pneumoniae sowie andere Gram-negative Bakterien wie Escherichia coli und Salmonella spp. dar [12,13] Es ist aber dann auf jeden Fall eine MRT zur Diagnosesicherung anzuschließen.…”

Section: Fallbericht Patientunclassified

“…Ob in jedem Fall eine Biopsie erfolgen soll, wird sehr kontrovers diskutiert. Völker und Kollegen vertreten die Meinung, dass aufgrund des erhöhten Risikos eines Eingriffes bei Säuglingen und Kleinkindern zunächst auf eine Intervention zum Keimnachweis verzichtet und eine kalkulierte Antibiotikagabe begonnen werden sollte [13]. Ähnlich sehen Principi und Esposito sowie Mohanty und Kollegen eine Indikation zur Nadelbiopsie nur bei Kindern, die nicht auf die antibiotische Therapie ansprechen, bei V. a. TBC oder zum Ausschluss einer malignen Erkrankung [10,12].…”

Section: Fallbericht Patientunclassified

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Unspezifische klinische Symptomatik bei 2 Kleinkindern mit Spondylodiszitis

Meyer‐Bahlburg¹,

Bruns²,

Bülow³

et al. 2019

Arthritis und Rheuma

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“…These severe complications are quite common in non-pyogenic infections, including cases due to Mycobacterium tuberculosis that are endemic in some developing and emerging countries but are diagnosed also in the industrialized world [2] [3] [4] [5] [6]. Early diagnosis and treatment might reduce these risks [9] [10]. Non-specific spondylodiscitis in children is caused by haematogenous spread of pathogens.…”

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confidence: 99%

Prevalence and Risk Factors of Infectious Spondylodiscitis in Benin’s Children

Zomalheto¹,

Assogba²,

Zannou³

2018

OJRA

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Aim: To determine the prevalence and risk factor of infectious spondylodiscitis in children in Benin. Patients and Method: A descriptive cross-sectional study over 5 years was conducted in rheumatology and paediatric departments of National Hospital University Hubert Koutoukou Maga of Cotonou among children suffered from osteoarticular disorders. We selected patients with infectious spondylodyscitis. The data collected were analyzed using SPSS 20.0 software. Results: Among 179 children treated for osteo-articular disorders, 29 (16.2%) had infectious spondylodiscitis. There were 11 girls and 18 boys (sex ratio = 1.55). The main symptoms were dominated by low back pain (72.4). Fever was present in 58.6% of patients. Laboratory parameters of inflammation were higher than normal in all of the patients. Paraparesia was present in one case. L2-L3 disc was most affected (45.2% of cases). Mycobacterium tuberculosis was incriminated in 75,8%. Common places germs were dominated by negative baccillus germs (62.5%). The treatment was medical with a minimum duration of 3 months. All patients were immobilized with a lumbostat over a period of 3 months. Sicle cells disease, HIV, no BCG vaccination were the risk factors identified respectively in 9.4%, 11.3% and 16%. Conclusion: Diagnosis of spondylodiscitis in children is difficult in our country Keeping in mind unspecific subjective complaints and clinical findings. Early diagnosis uses magnetic resonance imaging which cost high and remains beyond the reach of our patients. Therefore, effective antibiotic therapy should be started promptly as soon as the diagnosis is suspected to avoid serious complications.

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Spondylodiszitis im Kindes- und Jugendalter

Abstract: Elevated infectious laboratory values and back pain or other unspecific symptoms can indicate spondylodiscitis in children. MRI of the spine is necessary to rule out spondylodiscitis.

Cited by 8 publications

References 35 publications

Tumors and infections of the growing spine

Tumors and infections of the growing spine

Unspezifische klinische Symptomatik bei 2 Kleinkindern mit Spondylodiszitis

Prevalence and Risk Factors of Infectious Spondylodiscitis in Benin’s Children

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