Idiopathic intervertebral disk calcification in childhood: a case report and review of literature

Pediatric idiopathic intervertebral disk calcification (PIIVDC) is an uncommon entity affecting the intervertebral disks and adjacent vertebral body and musculoligamentous structures. More than 300 cases have been reported so far, but knowledge of PIIVDC is still fragmentary. The purpose of the study was to summarize the demographic and clinical characteristics of PIIVDC, and consider its treatment and natural history. This study is a review of 65 cases identified by literature search from 1990 to 2010. Male-to-female ratio was 40:25. Most patients (83%) were aged 5-12 years. Muscle pain was the most common manifestation (71.9%), followed by sensorimotor disturbance (20.3%) and fever (13.8%). Torticollis or scoliosis were noted in 23.4% of patients, and 15.4% were asymptomatic. The cervical spine was most frequently affected (64.6%), followed by the thoracic (26.2%), cervicothoracic (10.8%), lumbar (4.6%), and thoracolumbar (1.5%) spine. The C6/7 intervertebral disk was most frequently affected (35.7%), followed by C3/4 (21.4%), C2/3 (17.9%), C5/6 (14.3%), and C4/5 (10.7%). Erythrocyte sedimentation rate was the most sensitive laboratory indicator. Conservative treatment was adopted for 89.2% of patients and surgery for 10.8%. Neurological outcome was excellent except for one patient. PIIVDC appears to be a benign disorder associated with self-limiting inflammation. The natural history of PIIVDC will only be established by further experience with long-term follow-up periods into adulthood.