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The Journal of Bone and Joint Surgery (American) 86:1467-1472 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

The Natural History of Cervical Disc Calcification in Children

Li-Yang Dai, MD, PhD1, Hua Ye, MD2 and Qi-Rong Qian, MD, PhD3

1 Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Second Medical University, 1665 Kongjiang Road, Shanghai 200092, China. E-mail address: lydai{at}etang.com
2 Department of Radiology, Changhai Hospital, 174 Changhai Road, Shanghai 200003, China
3 Department of Orthopaedic Surgery, Changzheng Hospital, 415 Fengyang Road, Shanghai 200003, China

Investigation performed at the Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai, and the Department of Orthopaedic Surgery, Changzheng Hospital, Shanghai, China

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Calcification of cervical intervertebral discs is uncommon in children. The cases of approximately 200 children have been reported in the literature. The objective of the present study was to examine the natural history of this condition.

Methods: Seventeen consecutive children, ten boys and seven girls, with calcified cervical intervertebral discs were included in the study. The mean age at diagnosis was 7.7 years. Three children had had a fever, and two had a history of trauma. All of the children complained of neck pain except one who was asymptomatic and was identified by chance. On radiographs, the calcification was seen within the central part of the cervical intervertebral discs. All children had treatment of the symptoms, and they were then followed periodically until the disappearance of both the symptoms and the calcific deposits.

Results: The children were followed for a mean of five years, and all had a complete disappearance of both the symptoms and the calcification. None had recurrent symptoms or calcifications. The average time to resolution of the symptoms and the calcifications was 34.3 days (range, seventeen to 173 days) and fifteen months (range, three to sixty months), respectively. With the numbers available, factors such as age, level of disc calcification, severity of symptoms, and degree of spinal canal compromise were not related to the time of resolution.

Conclusions: Cervical disc calcification in children is a self-limiting condition with an excellent prognosis. Even if clinical symptoms due to nerve-root or spinal cord compression are present, conservative therapy produces satisfactory results. Therefore, nerve-root or spinal cord compression by a calcified cervical disc should not be considered an absolute indication for surgical intervention.

Level of Evidence: Prognostic study, Level IV (case series). See Instructions to Authors for a complete description of levels of evidence.


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