tailieunhanh - Cột sống ngực thắt lưng

Diskitis trẻ em có thể xảy ra ở cột sống ngực thắt lưng, hoặc xương cùng, và có thể ảnh hưởng đến trẻ em ở mọi lứa tuổi, Nhưng Nó IS MOST chung trong khu vực thắt lưng ở trẻ em nhỏ tuổi hơn 5 năm. Vật lý kiểm tra, kiểm tra phòng thí nghiệm, X quang và nghiên cứu tất cả các hỗ trợ trong việc chẩn đoán hội chứng lâm sàng này, | Childhood Diskitis Sean D. Early MD Robert M. Kay MD and Vernon T. Tolo MD Abstract Childhood diskitis may occur in the thoracic lumbar or sacral spine and can affect children of all ages but it is most common in the lumbar region in children younger than 5 years. Physical examination laboratory tests and radiologic studies all aid in the diagnosis of this clinical syndrome and proper use can prevent unnecessary invasive intervention. Presentation varies with age the child may refuse to bear weight on the lower extremities or may present with back pain abdominal pain a limp or if an infant or toddler with irritability. The etiology appears to be a bacterial infection usually caused by Staphylococcus aureus. Most children improve rapidly with a 4- to 6-week course of antibiotics. Although not routinely necessary immobilization decreases symptoms and in the case of osseous destruction prevents progression of spinal deformity. Biopsy of the infected disk space is reserved for children refractory to intravenous antibiotics. Follow-up should include plain radiographs at regular intervals for 12 to 18 months to ensure resolution of the destructive process. J Am Acad Orthop Surg 2003 11 413-420 Childhood diskitis represents one end of a continuum of spinal infections from diskitis to vertebral osteomyelitis with soft-tissue abscess. It has been recognized for decades in the pediatric population with consistent disagreement as to the etiology and optimal Diskitis is now generally accepted as a bacterial infection involving the disk space and adjacent vertebral end plates. Optimal management requires the use of intravenous antibiotics. Bracing does not seem to improve the clinical course but may be indicated with vertebral involvement to decrease pain and minimize deformity. Biopsy is not necessary for patients who exhibit all of the clinical characteristics but it is indicated for those whose symptoms do not resolve rapidly with treatment or who have .