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Spinal infections in children: a review
Patricia M de Moraes Barros Fucs1, Robert Meves, Helder Henzo Yamada
1Department of Orthopaedics and Traumatology, Santa Casa Medical School and Hospitals, São Paulo, SP, Brazil. patricia@fucs.com.br
International Orthopaedics
|October 29, 2011
Summary
Pediatric spondylodiscitis, affecting children aged 2-8, presents diagnostic challenges due to non-specific symptoms. Early MRI is crucial for detecting this spinal infection, which can lead to severe deformities if untreated.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Pediatric Radiology
Background:
- Spondylodiscitis in children (2-8 years) primarily affects the lumbar/lumbosacral spine.
- Diagnosis is challenging due to non-specific symptoms and communication difficulties in children.
- Children's vascularized intervertebral discs contribute to a higher incidence of this condition.
Purpose of the Study:
- To review the diagnostic and management strategies for pediatric spondylodiscitis.
- To highlight the importance of early and accurate diagnosis in preventing long-term spinal damage.
Main Methods:
- Literature review focusing on diagnostic modalities and treatment outcomes.
- Analysis of clinical presentation, laboratory findings, and imaging characteristics.
- Discussion of treatment protocols including antibiotics, immobilization, and surgery.
Main Results:
- Magnetic resonance imaging (MRI) offers high sensitivity and specificity for early pyogenic spinal infection detection.
- Radiographic changes on X-rays appear later (up to 6 weeks) and include endplate irregularity, erosion, and disc space narrowing.
- Untreated cases can result in vertebral collapse and permanent structural deformity, while effective treatment may lead to fusion.
Conclusions:
- Early diagnosis and prompt treatment are critical for favorable outcomes in pediatric spondylodiscitis.
- MRI is the preferred imaging modality for early detection.
- Multimodal treatment involving immobilization, antibiotics, and potentially surgery is essential.
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