Description
The video presents a lecture by Jayesh Trivedi discussing the occurrence and treatment of back pain in children. He outlines the rarity of this condition, indicating that while past studies estimated a 10% incidence, newer data suggests it may be as high as 30%. The lecture delves into common conditions causing back pain in the pediatric population, emphasizing that diagnosis in children often requires MRI for accuracy, as initial examinations yield conclusive diagnoses in only about 10% of cases. As children age, especially from the juvenile to adolescent stages, the types of conditions that present shift from potential malignancies to mechanical issues like spondylolysis and disc herniations.
Trivedi explains the epidemiology of back pain, identifying that juvenile cases often involve malignancies where the thoracic spine is affected, while adolescent cases are more mechanical in nature, focusing on the lower back. He discusses the need to differentiate between various causes of back pain, noting that psychosomatic issues are more diagnoses of exclusion in children with a family history of back problems. Common diagnoses include spondylolysis and disc herniations, with a detailed discussion of spondylolysis as the most frequent cause of adolescent back pain.
Specific attention is given to the mechanics of spondylolysis, including its definition, the anatomical defect in the pars interarticularis, and its examination techniques. The lecture covers symptoms, diagnostic imaging techniques (CT scans and MRIs), and management strategies, highlighting conservative treatments as the primary approach. Surgical interventions are deemed rare and reserved for non-responsive cases.
Trivedi also briefly touches on other categories of back pain-related disorders such as Scheuermann's disease, discitis, and tumors like osteoid osteoma. He emphasizes the importance of a thorough clinical evaluation and appropriate imaging to guide treatment decisions, with a clear algorithm for addressing pediatric back pain. The talk concludes with a summary aimed at equipping trainees with fundamental insights into pediatric back pain diagnosis and management.