[Imaging of non-traumatic spinal diseases in children]

Area of Science:

• Pediatric Radiology
• Pediatric Neurology
• Pediatric Orthopedics

Context:

• Spinal diseases in children manifest primarily through pain, with organic causes more prevalent in younger children and functional issues common in adolescents.
• Accurate diagnosis relies on a combination of clinical evaluation and advanced imaging techniques tailored to the child's age and suspected pathology.

Purpose:

• To outline the diagnostic imaging modalities for pediatric spinal conditions, emphasizing their appropriate use based on clinical presentation and suspected etiology.
• To highlight the importance of early and accurate diagnosis for managing spinal diseases in children, including congenital malformations and neoplasms.

Summary:

• Ultrasound is key for neonatal closed spinal dysraphia; radiography is the initial choice post-neonatal period after clinical assessment.
• Magnetic Resonance Imaging (MRI) is preferred for follow-up and excluding neoplasms. Computed Tomography (CT) and scintigraphy aid in diagnosing spondylolysis, tumors (e.g., osteoid osteoma), and pre/postoperative spine surgery.
• Management requires careful attention to hereditary spinal malformations, such as dysraphias, which can involve the entire central nervous system (CNS), as seen in myelomeningocele associated with Chiari II malformation, hydrocephalus, and hydromyelia.

Impact:

• Optimizing diagnostic strategies ensures timely intervention for pediatric spinal conditions, improving patient outcomes.
• Understanding the role of various imaging modalities aids clinicians in selecting the most effective diagnostic pathway, reducing unnecessary procedures and costs.
• Early identification and management of complex congenital spinal malformations can prevent severe neurological deficits and long-term complications.