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Douleurs rachidiennes de l'adolescent : point de vue de l'orthopédiste pédiatre

GENNARI JM; THEMAR NOEL C; PANUEL M; BENSAMOUN B; DESLANDRE C; LINGLART A; SOKOLOWSKI M; FERRARI A
REV CHIR ORTHOP TRAUMATOL , 2015, vol. 101, n° Suppl. 6, p. S72-S75
Doc n°: 175466
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.otsr.2015.06.012
Descripteurs : AD8 - DOULEUR, CA6 - PATHOLOGIE - RACHIS

Ten to twenty percent of persons experience spinal pain during
growth. Causes are diverse in adolescents, and it is essential to determine
etiology rapidly so as to guide optimal management. HYPOTHESIS: It is important
for the pediatric orthopedist to understand the natural history of conditions
inducing spinal pain. METHODS: A retrospective study included 116
adolescents presenting with spinal pain at the Hopital Nord (Marseille, France)
between January 1, 2009 and January 1, 2014. Malignant tumoral etiologies were
excluded. Mean patient age was 13.6 years. Risser ranged between >0 and <5.
Interview and clinical examination (skin, spine, neurologic examination, general
clinical examination) were systematic; depending on results, complementary
examinations (imaging, biology, biopsy) were prescribed. RESULTS: There were 32
cases of non-specific adolescent low back pain, 31 of lumbar or thoracolumbar
scoliosis, 23 of spinal growth dystrophy (Scheuermann's disease), 13 of isthmic
lysis, 5 of spondylolisthesis, 8 of transitional lumbosacral hinge abnormality, 2
of discal hernia, 1 of osteoid osteoma and 1 of eosinophil granuloma. Treatment
was often non-operative when diagnosis was sufficiently early. In case of
failure, surgery could generally be considered. DISCUSSION: Correctly indicated
non-operative management or surgery changes the natural history of these
pathologies. The aim of treatment is to resolve pain in adolescence, as it risks
becoming chronic and disabling by adulthood.
LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2015. Published by Elsevier Masson SAS.

Langue : FRANCAIS

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