Spine Problems in Children Flashcards
what is a red flag sign in children
back pain - low threshold for referral
scoliosis
lateral spinal curvature with secondary vertebral rotation
causes of scoliosis
idiopathic
2y to neuromuscular disease, tumour (eg osteoid osteoma), skeltal dysplasia or infection
who is idiopathic scoliois more common in
females
treatment of scoliosis
mild, non-progressive and doesn’t require surgery
larger curves require surgery for cosmesis/improve wheelchair posture
severe curves can result in restrictive lung defect - breathing difficulties
spondyloisthesis
slippage of one verterbae over another
usually occurs at L4/5 or L5/S1 level
what causes Spondylolisthesis
developmental defect or recurrent stress fracture of the pos elements which fails to heal
when does Spondylolisthesis usually present
adolescence - inc body weight and sport
Spondylolisthesis presentation
low back pain and may have radiculopathy with severe slippage
paradoxical flat back due to muscle spasm and can present accutely with waddling gait
kyphosis
anterior curvature of the spine, sometimes with lordosis of the lumbar spine
treat underlying cause if indicated
gibbus
form of structural kyphosis
not uncommon in elderly patients with osteoperosis as they may have wedge insufficiency fractures - los of height at anterior end of vertebral body but no height change at posterior end - angular deformity
when is a gibbus a particular concern
in young patient
underlying pathology suspected and careful history obtained. further imaging
(pain, particularly at night? Weight loss? Change in bowel habit?)
