Abstract
Background. Pathological vertebral fractures are rare and occur in inflammatory, tumor, and dystrophic lesions.
 Aim. This study aimed to analyze clinical features and morphological structure of pathological fractures of the spine in children.
 Materials and methods. The authors examined and operated 62 children aged 217 years for pathological vertebral fractures. We investigated the clinical, radiological, and morphological features.
 Results. The average age of children at the time of hospitalization was 10 years. Lesions of thoracic vertebrae prevailed (78%) with the maximum frequency of occurrence at the apex of physiological kyphosis Th78. In 10 cases, multiple lesions were noted, including the pathology of other parts of the skeleton. In 69% of observations, clinical symptoms were not dominated by mechanical back pain. Palpation pain (34%) and local spinal deformation (27%) were noted. On average, local kyphosis was 24. Eleven patients (18%) manifested a neurological deficiency, of which nine fractures were a consequence of the tumor process. In 16% of observations, the fracture of the vertebra was detected to be an accidental Х-ray finding. Among the radiation manifestations, all cases (12 patients) registered the decrease in the height of the vertebral body in the form of collapse. Destruction was manifested by various options other than blastic. Therapeutic and diagnostic interventions were performed in 56 patients, and in six children, manipulation was limited to trepan biopsy. The pathological fracture was caused by an inflammatory process in 50% of observations and tumors in 42%, of which 31% is malignant.
 Conclusions. Pathological spinal fracture in children should be considered as a syndrome, which in most cases is based on an inflammatory or tumor process. The high frequency of neoplastic, including malignant processes, requires active invasive diagnosis. Therapeutic tactics are determined by the clinical, radiation, and morphological characteristics of pathology.
Highlights
Pathological vertebral fractures are rare and occur in inflammatory, tumor, and dystrophic lesions
Lesions of thoracic vertebrae prevailed (78%) with the maximum frequency of occurrence at the apex of physiological kyphosis Th7–8
Eleven patients (18%) manifested a neurological deficiency, of which nine fractures were a consequence of the tumor process
Summary
ПАТОЛОГИЧЕСКИЕ ПЕРЕЛОМЫ ПОЗВОНОЧНИКА У ДЕТЕЙ (краткий обзор литературы и клинико-морфологический анализ моноцентровой когорты). Патологические переломы позвоночника у детей (краткий обзор литературы и клинико-морфологический анализ моноцентровой когорты) // Ортопедия, травматология и восстановительная хирургия детского возраста. Патологические переломы позвонков у детей встречаются относительно редко при воспалительных, опухолевых и дистрофических поражениях. Цель — анализ особенностей клинической картины и морфологической структуры патологических переломов позвоночника у детей. В 16 % наблюдений перелом позвонка оказался случайной лучевой находкой. В 50 % случаев патологический перелом был обусловлен воспалительным процессом, в 42 % — опухолью, из них в 31 % случаев — злокачественной. Патологический перелом позвоночника у детей следует рассматривать как синдром, в основе которого в большинстве случаев лежит воспалительный либо опухолевый процесс. Вследствие высокой частоты неопластических, в том числе злокачественных, процессов необходима активная инвазивная диагностика.
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