[Clinico-etiological correlations in children with sciatica]

During a period of 30 years 21 children with sciatic pains were treated at the Developmental Age Neurology, Medical Academy in Gdańsk. The aetiological factors and clinical manifestations were analysed. Nucleus pulposus prolapse was diagnosed in 5 children, in 9 cases neoplasms were found (in 3 cases malignant tumours of the sacral bone, intraspinal tumours in 6 cases); in 4 cases obliterative intraspinal arachnitis, and in 3 cases other causes were diagnosed. With the exception of one child the other ones were in the school-age group. In nearly all cases the onset was insidious. In one-third of children with neoplastic processes the neurological symptoms appeared after injuries and caused initially considerable diagnostic difficulties. In 18 cases disturbances of spinal configuration and mobility were observed. Pain produced by stretching was present in 20 cases. Sphincter disturbances were observed in 6 cases (including 5 with tumours). Motor defects were noticed in all patients, more pronounced in cases of tumours. Patency of the subarachnoid spinal space was without any greater importance for the diagnosis of sciatic pains. Raised protein level in the cerebrospinal fluid was highest in cases of intraspinal tumours, and it was moderately pronounced in obliterative arachnitis, while in nucleus pulposus prolapse the protein level varied. Plain films were of lower diagnostic importance, with the exception of sacral bone tumours and nucleus pulposus prolapse. Of greater importance were contrast medium radiological examinations of fluid spaces.