دورية أكاديمية
Chronic Nerve Root Injury in Pediatric Patients With Chronic Lumbar Stress Fractures: A Retrospective Review.
| العنوان: | Chronic Nerve Root Injury in Pediatric Patients With Chronic Lumbar Stress Fractures: A Retrospective Review. |
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| المؤلفون: | Tessendorf CD; University of South Dakota Sanford School of Medicine., Haddick KJ; University of South Dakota Sanford School of Medicine., McClellan JW; University of South Dakota Sanford School of Medicine. |
| المصدر: | South Dakota medicine : the journal of the South Dakota State Medical Association [S D Med] 2023 Jun; Vol. 76 (suppl 6), pp. s26. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: South Dakota State Medical Association Country of Publication: United States NLM ID: 101265265 Publication Model: Print Cited Medium: Print ISSN: 0038-3317 (Print) Linking ISSN: 00383317 NLM ISO Abbreviation: S D Med Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Sioux Falls, SD] : South Dakota State Medical Association, [2006]- |
| مواضيع طبية MeSH: | Fractures, Stress*, Adolescent ; Humans ; Child ; Retrospective Studies |
| مستخلص: | Introduction: Many orthopedic providers currently treat chronic spondylolysis as self-limited fractures. While the condition has previously been associated with back pain in pediatrics, there has been little attention on the risk of neurologic harm. Electromyography (EMG) is a common study used to evaluate nerve injury, but it has not been previously reported for testing pediatric patients with stress fractures. In this study, pediatric patients with chronic pars fractures and muscle extremity weakness who underwent EMG testing were reviewed to analyze their risk of chronic nerve injury. Methods: 120 pediatric patients who underwent EMG testing between 2015 and 2021 were analyzed, and 41(21F,20M) patients with a mean age of 16(13-20) met criteria of chronic lumbar pediatric spondylolysis with weakness on ankle dorsiflexion or plantarflexion. No exclusions were made. Initial EMG testing was indicated for the extremity weakness; pain was not the major concern. All exams were completed by JWM. Thin-cut lumbar CT studies were done at the same institution, and EMGs were completed by one of three physiatrists. EMGs were determined as normal, abnormal but not meeting chronic nerve injury threshold, or abnormal and meeting threshold for chronic nerve injury. Results: Of the 41 patients, 33 had bilateral and 8 had unilateral fractures with 95% (39/41) of them located at L4 or L5. 55% (18/33) of the bilateral fractures had abnormal EMGs and demonstrated chronic nerve injury; 1 had an abnormal EMG but did meet chronic injury threshold. 75% (6/8) of the unilateral fractures had abnormal EMGs and demonstrated chronic nerve injury; 1 had an abnormal EMG but did meet chronic injury threshold. Overall, 36% (15/41) had normal EMGs, 5% (2/41) had abnormal results but did not reach chronic injury threshold, and 59% (24/41) met threshold for chronic nerve injury. Conclusion: Chronic pars fractures have historically been treated as a benign and self-limited sports injury. However, our analysis showed that 59% of adolescent patients presenting with chronic pars fractures and dorsiflexion or plantarflexion weakness have developed a chronic nerve injury. This study is the first to demonstrate the risk of neurologic harm in unhealed pediatric lumbar stress fractures, and it indicates the importance of EMG testing in young patients presenting with chronic spondylolysis and extremity weakness. (Copyright© South Dakota State Medical Association.) |
| تواريخ الأحداث: | Date Created: 20230921 Date Completed: 20230922 Latest Revision: 20230922 |
| رمز التحديث: | 20240829 |
| PMID: | 37732929 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0038-3317 |
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