Structure and clinical manifestations of tumor and infectious destructive lesions of the cervical spine in children: 20-year single-center cohort data

Abstract

Aim. Analysis of the structure and clinical manifesta-tions of tumor and infectious pathology of the cervical spine in children. Design. Retrospective-prospective single- center cohort. Materials and methods. Data from 101 patients with a median age at the time of treat-ment of 7 years (min 11 months, max 17 years) were an-alyzed. Clinical, X-ray, CT, MRI and radioisotope research methods were used. The most common complaint was pain with an intensity of 5 (3.5–7) points on a visual ana-logue scale. Paresis and paralysis were noted in 14.9% of patients. The median duration of the diagnostic pause in the cohort was 3 (2–8) months. The structure of the established pathology: infectious spondylitis — 59.4%, non-bacterial spondylitis — 4.0%, tumors — 36.6%. The pathogen was verified in 31.7% of infectious cases. The tuberculous spondylitis is characterized by a large num-ber of affected vertebrae (Me=4) in comparison with nonspecific spondylitis (Me=1) and tumors (Me=1). The prevalence of the destructive process does not correlate with the duration of the diagnostic pause. A weak rela-tionship was noted between the levels of lesions of the cervical spine and the etiology of the process. Conclu-sion. Analysis of a single-center cohort demonstrates the etiological diversity of destructive lesions of the cer-vical spine in children, the absence of pathognomonic symptoms that can allow early diagnosis as well as the absence of vigilance of primary care physicians in rela-tion to this pathology