Investigation of Spinal Magnetic Resonance Imaging Results of Pediatric Patients Presenting with Low Back Pain

Yıl 2022, Cilt: 17 Sayı: 3, 193 - 197, 02.11.2022

Barış Erdogan , Bilgehan Kolutek Ay

https://doi.org/10.17517/ksutfd.1156487

Öz

Abstract

Objective: Low back pain in pediatric patients can be severe in terms of its consequences and should be investigated. In this study, the etiology of pediatric low back pain was examined, and it was evaluated whether there was a relationship between age and gender.

Material and Methods: In this study, 228 patients under 18 who applied to Şanlıurfa Training and Research Hospital Physical Medicine and Rehabilitation and Brain and Nerve Surgery polyclinics complained of low back pain and underwent spinal Magnetic Resonance Imaging (MRI) in 2021 were analyzed retrospectively.

Results: The ages of 228 patients included in our study ranged from 4 to 18 years, with a mean age of 12.8±2.5. 54.8% of the cases were male (n=125), 45.2% (n=103) were female. While MRI findings were not observed in 92 cases, MRI findings were found in 136 cases. Disc pathology was detected in 44.7% (n=102) of the cases, and structural pathology was found in 14.9% (n=36). The most common disc pathology was bulging, constituting 32.9% (n=75) of the cases. There was no significant difference between the genders of the cases according to the incidence of disc pathology (p=0.434). When age and incidence of disc pathology were evaluated, the age of the group with disc pathology was significantly higher than the group without disc pathology (p<0.001). The most common structural pathology in the cases was scoliosis, with no significant difference between the genders (p=0.083).

Conclusion: When faced with low back pain in children and adolescents, the patient should be evaluated in detail. It should not be forgotten that there may be low back pain due to non-specific muscle spasms and conditions such as disc diseases, scoliosis, listesis, neoplasm, infection, and congenital deformity that MRI can diagnose.

Anahtar Kelimeler

Child and adolescent patients, Disc pathologies, Low back pain

Bel Ağrısı Şikayeti ile Başvuran Çocuk Hastaların Spinal Manyetik Rezonans Görüntüleme Sonuçlarının İncelenmesi

Öz

Özet

Amaç: Çocuk hastalarda bel ağrısı sonuçları itibarı ile ciddi olabilen ve araştırılması gereken bir durumdur. Bu çalışmada çocuk bel ağrılarının etyolojileri incelendi, yaş ve cinsiyet ile ilişkisinin olup olmadığı değerlendirildi.

Gereç ve Yöntemler: Çalışmada 2021 yılında Şanlıurfa Eğitim ve Araştırma Hastanesi Fiziksel Tıp ve Rehabilitasyon ve Beyin ve Sinir Cerrahisi polikliniklerine bel ağrısı şikayeti ile başvurup Manyetik Rezonans Görüntüleme (MRG) yapılan 18 yaş altı 228 hasta retrospektif olarak incelendi.

Bulgular: Çalışmamıza katılan 228 olgunun yaşları 4 ile 18 arasında değişmekte olup ortalama yaş 12.8±2.5 idi. Olguların %54.8’i erkek olup (n=125), %45.2’si (n=103) kadındı. Olguların 92 tanesinde MRG bulgusu gözlenmezken 136 olguda MRG’de bulguya rastlanmıştır. Olguların %44.7’sinde (n=102) disk patolojisi saptanmış olup, %14.9’unda (n=36) yapısal patoloji saptanmıştır. En sık görülen disk patolojisi bulging olup olguların %32.9’unu (n=75) oluşturmakta idi. Disk patolojisi görülme durumlarına göre olguların cinsiyetleri arasında anlamlı farklılık yoktu (p=0.434). Yaş ile disk patolojisi görülme durumu

değerlendirildiğinde, disk patolojisi olan grubun yaşı olmayana göre anlamlı olarak yüksekti (p<0.001). Olgularda en sık görülen yapısal patoloji skolyoz olup, cinsiyetler arasında anlamlı farklılık yoktu (p=0.083).

Sonuç: Çocuk ve adolesan bel ağrıları ile karşılaşıldığında hasta ayrıntılı değerlendirilmeli, nonspesifik kas spazmına bağlı bel ağrıları olabileceği gibi MRG ile tanısı konabilen disk hastalıkları, skolyoz, listezis, neoplazm, enfeksiyon, konjenital deformite gibi durumlar olabileceği unutulmamalıdır.

Anahtar Kelimeler

bel ağrısı, çocuk ve adolesan hastalar, disk patolojileri

Kaynakça

• MacDonald J, Stuart E, Rodenberg R. Musculoskeletal Low Back Pain in School-aged Children: A Review. JAMA Pediatr. 2017;171(3):280-287.
• Andersson JA. Problems of classification of low back pain. Rheumatol Rehabil 1977;16(1):34–36.
• Calvo-Muñoz I, Gómez-Conesa A, Sánchez-Meca J. Prevalence of low back pain in children and adolescents: A meta-analysis. BMC Pediatr 2013;13:14
• 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.
• Yang S, Werner BC, Singla A, Abel MF. Low back pain in adolescents: A 1-Year analysis of eventual diagnoses. J Pediatr Orthop. 2017;37(5):344-347.
• Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003;81(9):646-656.
• Kordi R, Rostami M. Low back pain in children and adolescents: An algorithmic clinical approach. Iran J Pediatr. 2011;21(3):259-270.
• Ben Ayed H, Yaich S, Trigui M, Ben Hmida M, Ben Jemaa M, Ammar A. Prevalence, risk factors and outcomes of neck, shoulders and low-back pain in secondary-school children. J Res Health Sci. 2019;19(1):e00440.
• Jackson C, McLaughlin K, Teti B. Back pain in children: a holistic approach to diagnosis and management. J Pediatr Health Care. 2011;25(5):284-293.
• Taxter AJ, Chauvin NA, Weiss PF. Diagnosis and treatment of low back pain in the pediatric population. Phys Sportsmed. 2014;42(1):94-104.
• Royal College of Radiologists. Making the best use of clinical radiology services. Referral guidelines, 6th ed. 2007. Available at http://www.rcr.ac.uk (accessed 25 June 2022).
• Ramirez N, Flynn JM, Hill BW, Serrano JA, Calvo CE, Bredy R, Macchiavelli RE. Evaluation of a systematic approach to pediatric back pain: The utility of magnetic resonance imaging. J Pediatr Orthop. 2015;35(1):28-32.
• Feldman DS, Straight JJ, Badra MI, Mohaideen A, Madan SS. Evaluation of an algorithmic approach to pediatric back pain. J Pediatr Orthop. 2006;26(3):353-357.
• Erkintalo MO, Salminen JJ, Alanen AM,Paajanen HE, Kormano MJ. Development of degenerative changes in the lumbar intervertebral disk: Results of a prospective MR imaging study in adolescents with and without low-back pain. Radiology 1995;196:529-533.
• Partan G, Eyb R, Artacker G. Imaging of non-traumatic spinal diseases in children. Der Radiologue 2010;50:1107-1114.
• Lawrence JP, Greene HS, Grauer JN. Back pain in athletes. J Am Acad Orthop Surg. 2006;14(13):726-735.
• Postacchini F, Postacchini R. Operative management of lumbar disc herniation: The evolution of knowledge and surgical techniques in the last century. Acta Neurochir Suppl. 2011;108:17-21.
• Negrini S, Aulisa AG, Aulisa L, Circo AB, de Mauroy JC, Durmala J et al. 2011 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 2012;7(1):3.