Evaluation and Treatment of the Child with Acute Back Pain

Pediatr Clin North Am. 2023 Jun;70(3):545-574. doi: 10.1016/j.pcl.2023.01.013. Epub 2023 Mar 21.

Abstract

Back pain is common, in up to 30% of children, increasing with age. Eighty percent is benign, mechanical type, improving within 2 weeks of conservative care. Required for those not improving is in-depth evaluation, including MRI, laboratory, and peer consultations. Spondylolysis and spondylolisthesis comprise almost 10% of pediatric back pain, often caused by lumbar hyperextension activities and treated conservatively in most cases. Osteoid osteomas and osteoblastomas constitute the most common benign spinal tumors in childhood. Aggressive and malignant tumors of the spine are rare but when present require tertiary care referral and a comprehensive oncology team for optimal life-sustaining outcomes.

Keywords: Back pain children; Discitis; Risk factors; Spinal tumors; Spondylolisthesis; Spondylolysis.

Publication types

  • Review

MeSH terms

  • Back Pain / etiology
  • Child
  • Humans
  • Lumbosacral Region
  • Magnetic Resonance Imaging / adverse effects
  • Spondylolisthesis* / complications
  • Spondylolysis*