Pathological changes of the cervical spine in children with cervical pain syndrome

Background. Interpretation of cervical pain syndrome in children is complicated, resulting in delayed diagnosis of developmental juvenile osteochondrosis. Thus, updating the diagnostic methods of this pathology is particularly important.Aim. To improve methods of cervical spine diagnostics in children with cervical pain syndrome at the base of vertebral and basilar arteries using duplex ultrasound.Material and methods. The study cohort included 148 pediatric patients aged 4–18 years who were divided into two groups: a treatment group of 108 children with cervical pain syndrome and a control group of 40 healthy children. Clinical, radiological (ultrasound, X-ray, and MRI), and statistical methods were used for comparisons.Results. Duplex ultrasound of 108 patients revealed pathological changes of qualitative and quantitative features of C- or S-shaped, corner bend, mesh, excessive, and wave-shaped tortuosity deformities, as well as a reduction or expanse in diameter of one or two of the spinal arteries (SAs). The absence of an influence of osseous cervical spine structures on SAs was considered a sign of congenital genesis of SA deformity, while segmental instability of C2-C3 and/or C3-C4, atlanto-axial subluxation, and a Kimmerle anomaly were considered signs of extravascular compression of SAs. Regardless of the deformity genesis, blood flow was deficit in the vertebral basilar basin because of local hemodynamic disorders at the site of the deformity, particularly in older children. MRI revealed signs of intervertebral disc hypohydration at C2-C3 and/or C3-C4.Conclusion. Pathological changes in SAs of both congenital and acquired genesis resulted in hemodynamic disorders in the vertebral basilar basin in children with cervical pain syndrome, particularly older children.