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Vol. 17. Issue 4.
Pages 333-338 (January 2006)
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Vol. 17. Issue 4.
Pages 333-338 (January 2006)
Hernias discales calcificadas en la infancia
Calcified disc herniation in childhood
M. Ortega-Martínez
, J.M. Cabezudo, I. Fernández-Portales, L. Gómez-Perals, L.M. Bernal-García
Servicio de Neurocirugía. Hospital Regional Universitario Infanta Cristina. Badajoz
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Resumen

Las calcificaciones de los discos intervertebrales son muy infrecuentes en la infancia. Aunque su etiología no está clara, se sabe que no se relacionan con procesos degenerativos. Cursan con clínica inespecífica de raquialgias, contracturas musculares y, a veces, febrícula. Aunque ocasionalmente estos discos se hernian, causando dolor radicular o, mucho más raramente, déficits neurológicos o disfagia, la clínica desaparece en la mayor parte de los casos con tratamiento conservador, y sólo excepcionalmente se precisan tratamientos más agresivos. En nuestra revisión de la literatura hemos encontrado solamente 17 casos que requirieron tratamiento quirúrgico. En dos de estos casos el paciente estaba previamente diagnosticado de calcificaciones intervertebrales idiopáticas, pero no se habían descartado hernias preexistentes mediante resonancia magnética (RM). Presentamos un nuevo caso de una paciente diagnosticada a la edad de 10 años de calcificaciones discales idiopáticas, sin hernias discales en la RM, en la que 4 años después uno de los discos cervicales calcificados se hernió presentando un cuadro de radiculopatía cervical con déficit motor, precisando discectomía y artrodesis intersomática. Consideramos que este caso prueba definitivamente la teoría de Heinrich y cols., que considera la hernia calcificada en la infancia como la complicación de una patología previa, la calcificación del disco intervertebral. Se discuten los aspectos clínicos y terapéuticos de esta entidad.

Palabras clave:
Calcificación del disco intervertebral
Discectomía cervical
Hernia de disco calcificada
Hernia de disco en la infancia
Abreviaturas:
CIII
Summary

Calcification of intervertebral discs is a rare occurrence in children. Although the etiology of the calcification remains uncertain, it is no related with degenerative diseases. The clinical picture is non specific with neck pain, muscle contractures and, sometimes, low-grade fever. These symptoms generally disappear spontaneously, and surgery rarely becomes necessary. In our review of the literature, we have found only seventeen cases requiring surgical management. Two of these children had been previously diagnosed with calcified intervertebral discs, but at the time no herniation had been ruled out with magnetic resonance imaging (MRI). We report the case of a girl who was diagnosed, when she was ten years old, with intervertebral idiopatic calcifications. Four years later she presented with radiculopathy caused by the posterolateral displacement of a calcified cervical disc, wich required operative management. We think that this case supports the theory of Heinrich et al. that considers that the calcified hernia is a complication of a previous pathology, namely intervertebral calcification. Clinical and therapeutic aspects of this entity are discussed.

Key words:
Anterior discectomy
Calcified herniated disc
Calcified intervertebral discs
Herniated disc in childhood

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