Compression fractures of the spine in children: isn’t it time to change something?
https://doi.org/10.14531/ss2019.4.6-12
Abstract
Objective. To analyze the efficacy of various methods for treatment of children with compression fractures of the thoracic and lumbar spine on the basis of literature data.
Material and Methods. A systematic review of the literature on methods for the diagnosis and treatment of compression fractures of the spine in children was carried out. PubMed, Science Direct, and Google Scholar databases were searched for literature sources for analysis.
Results. A significant number of discrepancies between the approaches used in the treatment of compression fractures in children and the available literature data were noted. In particular, not any diagnostic protocol includes MRI as a tool to confirm the presence of a fracture, due to the high cost of the method and its low influence on the treatment tactic choice. The data of biomechanical studies cast doubt on the feasibility of long-term bed rest compliance and restrictions on sitting. As for bracing of patients with compression fractures, it has been demonstrated that wearing of rigid brace does not allow achieving better results in comparison with its absence. The child’s ability to remodel residual deformations of vertebral bodies ensures the restoration of their height and shape in the vast majority of cases. Currently, there is no data confirming the fact of earlier development of degenerative diseases and back pain in children who sustained compression vertebral fractures.
Conclusion. The review results allow to analyze the efficacy of various treatment methods and can be the basis for reviewing the existing treatment tactics for children with compression fractures of the vertebral bodies.
Material and Methods. A systematic review of the literature on methods for the diagnosis and treatment of compression fractures of the spine in children was carried out. PubMed, Science Direct, and Google Scholar databases were searched for literature sources for analysis.
Results. A significant number of discrepancies between the approaches used in the treatment of compression fractures in children and the available literature data were noted. In particular, not any diagnostic protocol includes MRI as a tool to confirm the presence of a fracture, due to the high cost of the method and its low influence on the treatment tactic choice. The data of biomechanical studies cast doubt on the feasibility of long-term bed rest compliance and restrictions on sitting. As for bracing of patients with compression fractures, it has been demonstrated that wearing of rigid brace does not allow achieving better results in comparison with its absence. The child’s ability to remodel residual deformations of vertebral bodies ensures the restoration of their height and shape in the vast majority of cases. Currently, there is no data confirming the fact of earlier development of degenerative diseases and back pain in children who sustained compression vertebral fractures.
Conclusion. The review results allow to analyze the efficacy of various treatment methods and can be the basis for reviewing the existing treatment tactics for children with compression fractures of the vertebral bodies.
About the Authors
N. O. Khusainov
The Turner Scientific Research Institute for Children’s Orthopaedics
Russian Federation
Russian Federation
MD, PhD, orthopedic traumatologist, researcher of the Department of spine pathology and neurosurgery
64–68, Parkovaya str., St. Petersburg, 196603, Russia
S. V. Vissarionov
The Turner Scientific Research Institute for Children’s Orthopaedics
Russian Federation
Russian Federation
MD, DMSc, Prof., Corresponding Member of the Russian Academy of Sciences, Deputy Director for science and academic work,
Head of the Department of spine pathology and neurosurgery
64–68, Parkovaya str., Pushkin, St. Petersburg, 196603, Russia
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Review
For citations:
Khusainov N.O., Vissarionov S.V. Compression fractures of the spine in children: isn’t it time to change something? Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2019;16(4):6-12. https://doi.org/10.14531/ss2019.4.6-12
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