OSTEOCHONDRITIS OF THE VERTEBRAL BODY

¹ Assistant Surgeon in Out Patient Department, Hospital for Ruptured and Crippled, New York; Associate Attending Surgeon in Orthopaedic Surgery and Chief of Clinic, United Israel Zion Hospital, Brooklyn, N. Y.

1. Vertebral osteochondritis is an entity distinct from vertebral epiphysitis though fundamentally they are similar processes with similar characteristics occurring at different growth periods.

2. Vertebral osteochondritis sets in during the first few years of life and is characterized by moderate or very slight pain, fatigue, night cries, muscle spasm, tenderness, deformity in the form of a knuckle or a generalized kyphosis or scoliosis.

3. Roentgenographically it is characterized by an irregularity of the vertebral outlines, flattening, and wedging of the vertebrae to be followed by the stage of restitution when the vertebral outlines appear dense and sclerosed. Deformity of the vertebral bodies is the final result. The intervertebral spaces are widened in proportion to the thinning of the vertebral bodies.

4. Of the five cases referred to in this communication, three were mistaken for Pott's disease and treated as such, one was mistaken for congenital scoliosis and only one was diagnosed as vertebral osteochronditis.

5. The etiology is unknown. From theoretical and analogous clinical observations and pathological studies it seems that an imbalance between the static demand and static capacity is a likely cause of this disturbance.

6. This static imbalance is most likely to occur during the first and second periods of rapid growth—in spine cases from birth to six years of age and about eleven to sixteen years of age.

7. All of the treated cases have done well under recumbency and plaster-of-Paris jacket treatment.

8. All of the treated cases have a remaining deformity which does not interfere with activity.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?