World journal of orthopedics · 2025
Spinal involvement in chronic recurrent multifocal osteomyelitis - diagnostics, treatment and what remains in the shadows: A literature review.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Petukhova Veronika V, Maletin Alexey S, Mushkin Alexander Yu, Kostik Mikhail M
Аннотация
BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory bone disorder primarily affecting children and adolescents. Spinal involvement in CRMO is common and can lead to significant clinical features and complications, including severe chronic back pain and spinal deformities with possible spinal cord compression.
AIM: To summarize the information about vertebral involvement in CRMO patients, including the clinical features, diagnostic approaches, and treatment outcomes.
METHODS: Sixty-three manuscripts (2005-2025) were found in PubMed, including case reports, retrospective cohort studies, randomized controlled trials, and imaging studies. The focus was on spinal involvement features, diagnostic imaging, treatment strategies, and long-term outcomes in pediatric CRMO patients.
RESULTS: Spinal involvement in CRMO ranges from 28% to 81% among patients with CRMO. Patients typically present with localized back pain, back stiffness, and, in more severe cases, spinal deformities such as kyphosis or scoliosis. Multifocal lesions are frequently observed, with the thoracic spine being the most commonly affected area. Whole-body magnetic resonance imaging (WBMRI) has emerged as the gold standard for effectively revealing multifocal bone lesions and spinal involvement. However, a bone biopsy is often needed to rule out infection or malignancy. Bisphosphonate treatment showed a high response rate (90.9%), while tumor necrosis factor-alpha (TNF-α) inhibitors were less effective (66.7%). Long-term follow-up is crucial, as relapses and progression of spinal deformities can occur even with treatment.
CONCLUSION: Spinal involvement in CRMO often leads to chronic pain, vertebral deformities, and rare spinal deformities. Early diagnosis using WBMRI, combined with treatment with bisphosphonates and TNF-α inhibitors, could improve outcomes.
AIM: To summarize the information about vertebral involvement in CRMO patients, including the clinical features, diagnostic approaches, and treatment outcomes.
METHODS: Sixty-three manuscripts (2005-2025) were found in PubMed, including case reports, retrospective cohort studies, randomized controlled trials, and imaging studies. The focus was on spinal involvement features, diagnostic imaging, treatment strategies, and long-term outcomes in pediatric CRMO patients.
RESULTS: Spinal involvement in CRMO ranges from 28% to 81% among patients with CRMO. Patients typically present with localized back pain, back stiffness, and, in more severe cases, spinal deformities such as kyphosis or scoliosis. Multifocal lesions are frequently observed, with the thoracic spine being the most commonly affected area. Whole-body magnetic resonance imaging (WBMRI) has emerged as the gold standard for effectively revealing multifocal bone lesions and spinal involvement. However, a bone biopsy is often needed to rule out infection or malignancy. Bisphosphonate treatment showed a high response rate (90.9%), while tumor necrosis factor-alpha (TNF-α) inhibitors were less effective (66.7%). Long-term follow-up is crucial, as relapses and progression of spinal deformities can occur even with treatment.
CONCLUSION: Spinal involvement in CRMO often leads to chronic pain, vertebral deformities, and rare spinal deformities. Early diagnosis using WBMRI, combined with treatment with bisphosphonates and TNF-α inhibitors, could improve outcomes.