[Low back pain among children and adolescents].
OBJECTIVE
We presented our experience with the diagnosis and treatment of low back pain in children.


METHODS
We retrospectively reviewed 29 children (15 girls, 14 boys; mean age 12 years; range 9 to 17 years) who were treated for low back pain and had appropriate follow-ups. Etiologic causes were sought by clinical evaluation, radiologic studies, and laboratory tests. Patients with unknown etiology underwent symptomatic treatment. The mean follow-up period was 42 months (range 12 to 96 months).


RESULTS
Etiology was determined in 26 patients (89%), which included spondylolysis/spondylolisthesis (n=8), Scheuermann's disease (n=6), neoplasia (n=5), discitis/vertebral osteomyelitis (n=4), and lumbar disc herniation (n=3). Spondylolysis was managed conservatively, except for one patient who had in situ spinal fusion for associated spondylolisthesis. Five patients with Scheuermann's disease were treated conservatively, while one patient required spinal fusion. Surgical treatment with biopsy, curettage, and bone grafting was performed for all neoplasias, but one which was followed-up conservatively. Two patients with discitis were managed with antibiotic treatment and two patients with vertebral osteomyelitis (Pott's abscess) underwent both medical treatment and surgical drainage and stabilization with strut graft. Lumbar disc herniation was treated conservatively in two patients, while one had surgical treatment with excision of disc fragments and limited laminectomy. Finally, all the patients became asymptomatic on final examinations.


CONCLUSIONS
Serious consideration should be given to persistent low back pain in children. Clinical, radiologic, and laboratory findings can be elaborated into etiologic diagnoses and complete relief can be achieved with appropriate treatment.
Bezer
Murat
M
Department of Orthopedics and Traumatology, Medicine Faculty of Marmara University, Istanbul, Turkey.
Erol
Bülent
B
Kocaoğlu
Bariş
B
Aydin
Nuri
N
Güven
Osman
O
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D017116:Low Back Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008499:Medical Records; D010019:Osteomyelitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D011859:Radiography; D012189:Retrospective Studies; D012544:Scheuermann Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D013122:Spinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D013169:Spondylolysis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology