By D. Mazin. Harris-Stowe State College.
In addition to Pediatr Surg 26: 995–9 the destructive form levitra professional 20 mg fast delivery psychological erectile dysfunction young, there is also a benign best levitra professional 20mg erectile dysfunction humor, self-limiting 8. Dormans JP, Criscitiello AA, Drummond DS, Davidson RS (1995) form restricted to the disk. The disk is almost always af- Complications in children managed with immobilization in a halo fected in this condition. J Bone Joint Surg (Am) 77: 1370–3 ment of the disk hardly ever occurs in growing patients. Durkin M, Olsen S, Barlow B, Virella A, Connolly E (1998) The epi- demiology of urban pediatric neurological trauma: evaluation of, and implications for, injury prevention programs. Floman Y, Kaplan L, Elidan J, Umansky F (1991) Transverse liga- Spondylodiscitis is induced by specific or non-specif- ment rupture and atlanto-axial subluxation in children. The commonest non-specific pathogen Joint Surg (Br) 73: 640–3 is Staphylococcus aureus [2, 3, 10]. Specific spondylitis dally and possibly also into the legs or the abdomen. Small is caused by Mycobacterium tuberculosis (human type, children refuse to walk or sit, and often are no longer able rarely bovine type). During the clinical examination, rare illness in Central Europe since BCG vaccination, it the child prefers to adopt a lying position. Skele- symptoms are not usually present, and a high fever is not 3 tal tuberculosis is a typical illness suffered by children, and especially typical. The erythrocyte sedimentation rate and the spine is particularly frequently affected [5, 6, 11, 12]. Pathogenesis In cases of specific spondylitis, in particular, laboratory In small children, blood vessels pass from the endplates parameters of infections are almost invariably absent. If into the disks, allowing bacteria to enter the disk by septic temperatures are measured, blood cultures should hematogenous transmission. Con- Radiographic findings sequently, the infection always begins in the bone next to The first sign on the x-ray is usually the narrowing of the the disk in adolescents and adults, but usually directly in intervertebral space at the affected level (⊡ Fig. Occurrence Increased uptake on a bone scan, and particularly a leu- Spondylodiscitis is a rare condition. Fairly large series of spondylitis TB have a scan should always be recorded in the early stage if the been described in Hong Kong, India and South x-ray is normal and the clinical findings are suggestive Africa. The hyperemia near Clinical features, diagnosis the affected disk leads to changes that typically appear hypointense on T1-weighted images and hyperintense! Spondylodiscitis generally occurs in small children on T2-weighted images (⊡ Fig. In this age group one should narrowing visible on the x-ray as an early sign is not always consider the possibility of spondylitis when usually detected on the MRI scan, but only becomes back pain occurs. Even tuberculous spondylitis can apparent after the inflammatory edema has regressed. CT does not make any further contribution to the body and not the intervertebral disk. Osteoblastoma is also common, puncture, which is always indicated if spondylitis TB is but is generally located in the pedicle and is therefore suspected (⊡ Fig. This suspicion is then confirmed unlikely to be confused with spondylodiscitis. Additionally, the Children with spondylodiscitis should be admitted to patient’s history itself can provide helpful information. Ideally the spine is immobilized in a plaster A puncture biopsy is also indicated if the infection fails brace or a body cast. The puncture is per- or cast is to alleviate the pain by immobilization. Since formed under anesthesia from the dorsal side with a the spondylodiscitis is frequently located in the lumbar wide-bore needle and with image intensifier control. Since the affected vertebral body is approached on the lateral side pathogen usually remains unknown, the anti-infective of the pedicle and punctured directly. The collected pus is treatment cannot be targeted specifically and the anti- investigated as a direct preparation and in an animal test. They should be broad-spectrum preparations ture is indicated generally in spondylodiscitis.
9 of 10 - Review by D. Mazin
Votes: 82 votes
Total customer reviews: 82