PURPOSE Discitis in the paediatric population poses diagnostic challenges due to non-specific presenting symptoms and difficulty with expressing pain in non-communicating children. Discitis remains a relatively rare condition in the paediatric population and previous reports are limited to small cohorts. In this article, we report our experience in management of discitis over a 10-year period and review the literature on this topic. METHODS We retrospectively reviewed cases of paediatric discitis/spondylodiscitis over a 10-year period between 2008 and 2018 managed in our regional paediatric neurosurgery unit. Relevant demographic information, microbiological data, blood investigation profile, antibiotic treatment duration and clinical outcomes were interrogated from clinical notes and electronic databases and further analysed. RESULTS Overall, 21 cases of paediatric discitis were identified from year 2008 to 2018 with a female to male ratio of 1.3:1. The mean age at presentation was 4.3 years (range 1 to 15 years). Overall, there were 19 cases of lumbosacral/lumbar, 1 thoracic and 1 cervical discitis. The mean duration of follow-up was 20 months (range 6 to 69 months). The most common presenting features were back pain and refusal to walk/sit or weight bear. Erythrocyte sedimentation rate (ESR) was found to be more sensitive than C-reactive protein (CRP) (sensitivity 78% versus 38%) in our cohort. Computer tomography (CT)-guided biopsy was performed in five cases and only one of these was positive (20%). All patients were treated with intravenous antibiotics with resolution of discitis. CONCLUSIONS Presentation of discitis in children can be non-specific and requires high index of suspicion. CT-guided biopsy in our cohort revealed a low rate of positive cultures. Despite negative blood cultures and CT-guided biopsy results, empirical intravenous antibiotics were effective in treating discitis successfully. In our cohort, low yield of CT-guided biopsy does not support its use on each case and this may be reserved for cases resistant to antimicrobial therapy or concerns regarding other pathology mimicking infection. Better understanding and awareness of this condition and its pathophysiology can lead to timely imaging, diagnosis and treatment.

中文翻译：

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小儿脊柱炎：在管理和临床结果方面有10年单一机构经验。

目的儿童小儿椎间盘炎由于非特异性的表现症状和在非交流儿童中表达疼痛的困难而给诊断带来了挑战。椎间盘炎在儿科人群中仍然是一种相对罕见的疾病，以前的报道仅限于小规模人群。在本文中，我们报告了我们在处理椎间盘炎方面的10年经验，并回顾了有关该主题的文献。方法我们回顾性研究了2008年至2018年10年间在我们区域儿童神经外科部门管理的小儿椎间盘炎/脊椎盘炎的病例。从临床记录和电子数据库中查询了相关的人口统计学信息，微生物学数据，血液调查资料，抗生素治疗持续时间和临床结果，并进行了进一步分析。结果总体而言，从2008年到2018年，确定了21例小儿椎间盘炎病例，男女之比为1.3：1。报告时的平均年龄为4.3岁（范围为1至15岁）。总体上，有19例腰s部/腰部，1例胸椎和1例颈椎间盘炎。平均随访时间为20个月（6个月至69个月）。最常见的表现是背部疼痛和拒绝走路/坐着或负重。在我们的队列研究中，发现红细胞沉降率（ESR）比C反应蛋白（CRP）敏感（敏感度分别为78％和38％）。在5例中进行了计算机断层扫描（CT）引导的活检，其中只有1例呈阳性（20％）。所有患者均接受了解决椎间盘炎的静脉抗生素治疗。结论儿童椎间盘炎的表现可能是非特异性的，需要高度怀疑。在我们的队列中，CT引导的活检显示阳性培养率较低。尽管血液培养阴性和CT引导下的活检结果，经验性静脉注射抗生素仍可成功成功地治疗椎间盘炎。在我们的队列中，CT引导活检的低产率并不支持在每种情况下的使用，这可能保留给对抗菌治疗有抗药性或与其他模仿感染的病理相关的问题。对这种情况及其病理生理的更好的理解和认识可以导致及时的成像，诊断和治疗。经验性静脉注射抗生素可成功治疗椎间盘炎。在我们的队列中，CT引导活检的低产率并不支持在每种情况下的使用，这可能保留给对抗菌治疗有抗药性或与其他模仿感染的病理相关的问题。对这种情况及其病理生理的更好的理解和认识可以导致及时的成像，诊断和治疗。经验性静脉注射抗生素可成功治疗椎间盘炎。在我们的队列中，CT引导活检的低产率并不支持在每种情况下的使用，这可能保留给对抗菌治疗有抗药性或与其他模仿感染的病理相关的问题。对这种情况及其病理生理的更好的理解和认识可以导致及时的成像，诊断和治疗。