Abstract
Objective: Incidental
findings about vertebras or intervertebral discs, detected at MRI exams in
adults is a widely studied subject and there is vast amount of detailed
information about this. However, in the pediatric population, there is not
enough number of studies to define the incidence and prevalance of degenerative
spine diseases. In this study, we aimed to detect the incidence of degenerative
spine diseases in pediatric population by using archived MRI scans which were
performed with indications other than degenerative spine diseases.
Material and Methods: MRI scans, performed with indications other than degenerative
spine diseases, between 2015-2017 were retrospectively examined to determine
relevant findings. Thirty-one patients are included in the study.
Results: Pfirrmann 2
degenerations were detected in 5 (16%) patients, Pfirrmann 3 degenerations were
present in 4 (12%) patients. There was no patient classified as Pfirrmann 4 or
5 subgroup. Modic type 1 degeneration were present in one patient while there
was one patient with Modic type 2 degeneration. We found disc bulging at L2-L3 intervertebral
disc in a 17 year-old male patient.
Conclusion: Degenerative
spine patologies can be found in pediatric population, even though they are
rare. MRI exams are very successful in detecting the pathologies even in
asymptomatic patients. Defining the incidence and prevelance of degenerative
spine findings in pediatric population can provide more accurate diagnosis by
creating an awareness.
References
- Ramadorai U, Hire J, DeVine JG, Brodt ED, Dettori JR. Incidental findings on magnetic resonance imaging of the spine in the asymptomatic pediatric population: a systematic review. Evid Based Spine Care J. 2014; 5(2): 95-100.
- Leboeuf-Yde C, Kyvik KO. At what age does low back pain become a common problem? A study of 29,424 individuals aged 12-41 years. Spine. 1998; 23(2): 228-34.
- Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents. Spine. 1996; 21(20): 2323-8.
- Jeffries LJ, Milanese SF, Grimmer-Somers KA. Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine. 2007;32(23):2630-7.
- Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72(3):403-8.
- Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69-73.
- Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 2001;26(17):1873-8.
- Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J. 2014;14(11):2525-45.
- Jensen MC, Kelly AP, Brant-Zawadzki MN. MRI of degenerative disease of the lumbar spine. Magn Reson Q. 1994;10(3):173-90.
- Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984;66(5):699-707.
- Urrutia J, Zamora T, Prada C. The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool. Eur Spine J. 2016;25(2):596-601.
- Paajanen H, Erkintalo M, Parkkola R, Salminen J, Kormano M. Age-dependent correlation of low-back pain and lumbar disc regeneration. Arch Orthop Trauma Surg. 1997;116(1-2):106-7.
- Kjaer P, Leboeuf-Yde C, Sorensen JS, Bendix T. An epidemiologic study of MRI and low back pain in 13-year-old children. Spine. 2005;30(7):798-806.
- Tertti MO, Salminen JJ, Paajanen HE, Terho PH, Kormano MJ. Low-back pain and disk degeneration in children: a case-control MR imaging study. Radiology. 1991;180(2):503-7.
- Ramirez N, Flynn JM, Hill BW, Serrano JA, Calvo CE, Bredy R, et al. Evaluation of a systematic approach to pediatric back pain: the utility of magnetic resonance imaging. J Pediatr Orthop. 2015;35(1):28-32.
Abstract
Amaç: Erişkin
popülasyonda asemptomatik hastalarda Manyetik Rezonans Görüntüleme (MRG)
tetkiki sırasında saptanan insidental bulgular, iyi dokümante edilmiş ve bu
konuda detaylı araştırmalar yayınlanmıştır. Bu sayede MRG’nin yüksek
duyarlılıkta bir görüntüleme metodu olduğu anlaşılmıştır. Bu gerçek, muhtemelen
pediyatrik yaş grubundaki hastalar için de geçerlidir. Ancak pediyatrik yaş grubunda dejeneratif omurga
hastalıklarının insidans ve prevelansını yansıtan yeterli sayıda çalışma mevcut
değildir. Çalışmamızda pediyatrik yaş grubunda, dejeneratif hastalık dışındaki
tanılarla elde edilmiş abdominal veya pelvik MRG’ler incelenerek kemik ya da disk ile ilişkili dejeneratif
bulguların sıklığını tespit etmeyi hedefledik.
Gereç ve Yöntem:
Çalışma kurumumuz eğitim planlama komisyonundan
onay alınarak gerçekleştirilmiştir. 2015-2017 yılları arasında pediatrik yaş
grubuna dejeneratif hastalıklar dışı endikasyonlarla gerçekleştirilen abdominal
ve pelvik MRG incelemeleri
geriye dönük olarak taranmış ve 31 hasta çalışmaya dahil edilmiştir.
Bulgular: 5
(%16.1) hastanın Pfirrmann Tip 2, 4 (%12.9) hastanın ise Pfirrmann Tip 3 olarak
değerlendirilen disk dejenerasyonları mevcuttur. Pfirrmann Tip 4 ya da 5 olarak
sınıflanabilecek disk tespit edilmemiştir. Bir hastada Modic Tip 1 (16 yaşında
kadın), bir hastada (15 yaşında kadın) ise Modic Tip 2 dejenerasyon tespit
edilmiştir. Bir hastada (17 yaşında erkek), L2-L3intervertebral
diskinde periferal disk kabarıklığı saptanmıştır.
Sonuç: Pediyatrik yaş grubunda dejeneratif vertebra ve disk bulguları nadir de
olsa görülebilmektedir. MRG asemptomatik bireylerde dahi mevcut patolojileri
tespit etmede güçlü bir yöntemdir. Pediyatrik hastalarda dejeneratif vertebral
kolumna ait bulgularının sıklığının tespit edilmesi, bu alandaki farkındalığı
ve doğru tanı koyma oranlarını arttıracaktır.
References
- Ramadorai U, Hire J, DeVine JG, Brodt ED, Dettori JR. Incidental findings on magnetic resonance imaging of the spine in the asymptomatic pediatric population: a systematic review. Evid Based Spine Care J. 2014; 5(2): 95-100.
- Leboeuf-Yde C, Kyvik KO. At what age does low back pain become a common problem? A study of 29,424 individuals aged 12-41 years. Spine. 1998; 23(2): 228-34.
- Burton AK, Clarke RD, McClune TD, Tillotson KM. The natural history of low back pain in adolescents. Spine. 1996; 21(20): 2323-8.
- Jeffries LJ, Milanese SF, Grimmer-Somers KA. Epidemiology of adolescent spinal pain: a systematic overview of the research literature. Spine. 2007;32(23):2630-7.
- Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990;72(3):403-8.
- Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2):69-73.
- Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 2001;26(17):1873-8.
- Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J. 2014;14(11):2525-45.
- Jensen MC, Kelly AP, Brant-Zawadzki MN. MRI of degenerative disease of the lumbar spine. Magn Reson Q. 1994;10(3):173-90.
- Fredrickson BE, Baker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984;66(5):699-707.
- Urrutia J, Zamora T, Prada C. The prevalence of degenerative or incidental findings in the lumbar spine of pediatric patients: a study using magnetic resonance imaging as a screening tool. Eur Spine J. 2016;25(2):596-601.
- Paajanen H, Erkintalo M, Parkkola R, Salminen J, Kormano M. Age-dependent correlation of low-back pain and lumbar disc regeneration. Arch Orthop Trauma Surg. 1997;116(1-2):106-7.
- Kjaer P, Leboeuf-Yde C, Sorensen JS, Bendix T. An epidemiologic study of MRI and low back pain in 13-year-old children. Spine. 2005;30(7):798-806.
- Tertti MO, Salminen JJ, Paajanen HE, Terho PH, Kormano MJ. Low-back pain and disk degeneration in children: a case-control MR imaging study. Radiology. 1991;180(2):503-7.
- Ramirez N, Flynn JM, Hill BW, Serrano JA, Calvo CE, Bredy R, et al. Evaluation of a systematic approach to pediatric back pain: the utility of magnetic resonance imaging. J Pediatr Orthop. 2015;35(1):28-32.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | April 30, 2018 |
| Submission Date | September 18, 2017 |
| Published in Issue | Year 2018 Volume: 20 Issue: 1 |
Cite
Bu Dergi, Kırıkkale Üniversitesi Tıp Fakültesi Yayınıdır.