EPIPHYSITIS OF THE SPINE

¹ BOSTON, MASSACHUSETTS

Epiphysitis of the spine is a relatively common lesion. Sixty-nine of our seventy-five patients were seen during the past six years. Most of these patients visited the hospital for the treatment of faulty posture; roentgenograms were essential for diagnosis. The disease was seen most frequently in rapidly growing children. In fourteen patients there was a familial history of similar spinal lesions. Laboratory studies upon these patients were essentially negative. Roentgenograms showed irregularity of the upper and lower surfaces of the vertebral bodies as the most constant finding. Decalcification of the vertebrae was observed in only eight patients. So-called Schmorl's islands were seen in twenty-one. The late change was constantly an anterior wedging of the vertebral body. All gradations of severity of the lesion were observed. With treatment, deformity was decreased, but rarely corrected. In two cases no deformity developed. In most instances treatment consisted in the application of a plaster jacket with the spine in extension and corrective exercises. During the acute early stage of the disease, recumbency in a plaster shell with the thoracic spine in extension, as was carried out in five cases, seemed to be the most efficient form of treatment. In our adult patients who had received no treatment or inadequate treatment, severe deformity was usually present. This was commonly associated with pain and weakness in the back.

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