Ernia calcifica di nucleo polposo in età pediatrica

Author： Brambilla S.   Mondini Trissino da Lodi A.   Usellini E.  

Publisher： Springer Publishing Company

ISSN： 0390-7368

Source： Archivio di Ortopedia e Reumatologia, Vol.121, Iss.2-3, 2010-11, pp. : 34-35

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Abstract

Calcification of the intervertebral disk in childhood is a rare occurrence. Approximately 200 pediatric cases have been reported in literature since its first description by Baron in 1924. Rarer and usually asymptomatic at the thoracic and lumbar level, they are instead relatively more frequent and symptomatic in the cervical spine; they have mainly a benign evolution and a spontaneous regression. The calcifications present three radiographic evolutionary appearances: •</itemnumber> homogeneous and regular calcification </itemcontent> </listitem> •</itemnumber> fragmented and irregular calcification </itemcontent> </listitem> •</itemnumber> protruded and herniated calcification. </itemcontent> </listitem> </orderedlist> The two latter radiological aspects are usually concomitant to the appearance of the painful crisis and precede the disappearance of the calcification; the posterior herniation of the calcified disc is a still rarer occurrence. The symptomatic type is usually confined to the cervical level and presents with acute onset of pain and decreased range of motion of the neck. Only few cases present objective neurological findings. The course is favourable with regression of clinical signs and spontaneous disappearance of the herniated calcified fragment. Conservative treatment is recommended also in cases with initial neurological signs. Surgical treatment is reserved only in those cases that present serious neurological damage. This paper reports the case of a nine-year-old child with a posterior herniation of a calcified intervertebral disk at C2–C3 level. The treatment was conservative with resorption of the herniated calcified disc material and complete regression of symptoms.

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