Eosinophilic granuloma in the pediatric spine.
OBJECTIVE
Eosinophilic granuloma (EG) involving the vertebrae in the pediatric population presents a difficult management scenario. Issues of surgical versus nonsurgical intervention, spinal stability and continued skeletal growth must all be considered.


METHODS
A retrospective review of medical records and radiographs from 1964 to the present yielded 12 patients with age less than 18 at the time of diagnosis of primary spinal EG.


RESULTS
Eleven of these 12 patients presented with pain; 2 patients had neurological deficits. Nine patients were managed nonsurgically, including those undergoing tissue diagnosis by needle (2) or extraspinal (3) biopsy; 3 patients underwent gross total resections. Radiographic diagnosis alone was made in 4. With an average follow-up of 8.1 years, survival is 100%.


CONCLUSIONS
EG in the spine infrequently produces neurological deficits in the pediatric age group, although it may result in spinal instability. As such, nonsurgical management is the preferred strategy to effect symptomatic relief.
Greenlee
Jeremy D W
JD
Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Fenoy
Albert J
AJ
Donovan
Kathleen A
KA
Menezes
Arnold H
AH
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004803:Eosinophilic Granuloma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019637:Orthopedic Procedures; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
D000970:Antineoplastic Agents