Juvenile Spondylolysis Osteochondrosis

　　Regarding the etiology of the disease, some scholars believe that the disease is aseptic necrosis of the annular epiphysis. The vertebral body has three ossification centers, namely the primary ossification center in the middle of the vertebral body and the secondary ossification centers at the upper and lower ends of the vertebral body, which are called annular epiphysis. They appear after 4 years old and are located at the edge of the cartilage plate, separating the vertebral body from the intervertebral disc. However, this statement has been refuted. The currently more widely accepted explanation is: the main lesion is in the intervertebral cartilage. It is because there is a congenital or developmental defect at the junction of cancellous bone and cartilage. When overloaded, the nucleus pulposus of the intervertebral disc protrudes into the vertebral body, destroys the cartilage plate of the vertebral body, causing growth imbalance; at the same time, the intervertebral disc also loses its shock absorption (protection) function, causing excessive pressure on the anterior margin of the vertebral body, causing growth delay, wedge-shaped change of the vertebral body, and fragmentation. The posterior margin of the vertebral body is protected by the posterior articular process and maintains its original height, causing the spine to produce posterior curvature deformity.

　　Juvenile spondylolysis often occurs during the rapid growth period of adolescents, and the vast majority of patients seek medical attention mainly because of humpback deformity. Some patients may have back pain, and 50% of patients report that the pain is mainly located in the deformed part or lower back, which worsens after activity and usually subsides as growth ends. After approaching maturity, only 25% of patients have more typical symptoms. If the pain is located in the waist while the deformity is in the chest, it should be considered that the possibility of spondylolysis.

　　Humpback is the main symptom, accompanied by stiffness of the spine, the neck is often curved, the shoulders are下垂, the chest is narrow and flat, the scapula is prominent, and the pain is not severe, often hidden pain. The humpback deformity progresses progressively after 20 years old.

　　It is now believed that the congenital developmental abnormality is one of the causes of the disease, so there is no effective preventive measure. However, it should be noted that although this disease is a self-healing disease with an active period of about 2 years, if there is a humpback deformity, it is impossible to be completely corrected. Early osteoarthritis may occur in adulthood. Therefore, once diagnosed with the disease, it is necessary to actively treat it.

　　The auxiliary examination of this disease is mainly X-ray examination, which is manifested as:

　　10. Irregular grooves are present at the upper and lower front edges of the vertebral bodies, and the shape and size of the corresponding parts of the annular epiphysis are uneven and separate from the vertebral bodies.

　　9. Multiple vertebral bodies show wedge-shaped changes in front, accompanied by Schmorl nodules.

　　8. Mild narrowing of the vertebral disc space.

　　7. Thoracic or thoracolumbar posterior curvature deformity exceeds normal 25° to 40°.

　　6. Early osteoarthritis and bone spurs appear at the anterior margin of the vertebral bodies in adulthood.

　　Dietary calcium supplementation for osteomalacia

　　1. Shrimp and tofu soup:50 grams of dried shrimp, cleaned and soaked; 200 grams of soft tofu, cut into small cubes; add scallion, ginger juice, and cooking wine, sautéed in oil and then add water to boil into soup. It can fully supplement calcium, and regular consumption is effective.

　　2. Shrimp Skin and Rapeseed Stir-fried Dried Bean Curd:Shrimp skin 50 grams, rapeseed 250 grams, dried bean curd 2 pieces, cut into shreds; stir-fry in the oil pot as usual, can be eaten regularly.

　　3. Shrimp Skin Stir-fried Chive:Shrimp skin 50 grams, wash and soak; chive 250 grams, wash and cut into sections, stir-fry chive for several minutes in a hot oil pot, add shrimp skin and stir-fry, add table salt, cooking wine, and ginger juice, then add shrimp skin and stir-fry over high heat, add table salt for seasoning and serve.

　　4. Shrimp Skin and Scallion Braised Pork Shreds:Shrimp skin 50 grams, scallion 25 grams (cut into small pieces), pork 100 grams (cut into shreds), first stir-fry scallion and pork shreds in the oil pot, add cooking wine and ginger juice, then add shrimp skin and stir-fry over high heat, add table salt for seasoning and serve.

　　5. Shrimp Skin Fried Eggs:Shrimp skin 50 grams, wash and soak; 3 eggs, crack and beat evenly. In the oil pot, first fry the eggs into a golden yellow color, then add scallion and ginger juice, add shrimp skin and stir-fry for several minutes, add iodized salt for seasoning and serve.

　　6. Milk and Jujube Porridge:Boil milk, rice, and jujube porridge, eat regularly, and it can treat physical weakness and deficiency of Qi and blood.

　　7. Milk Drink:250 milliliters of milk, taken with breakfast every morning, regular consumption can supplement calcium.

　　(The above information is for reference only, please consult a doctor for details)

　　This disease is a self-healing disease with an active period of about 2 years. If there is a hunchback deformity, it is impossible to correct it completely, and early secondary osteoarthritis may occur after adulthood. The purpose of treatment is to prevent deformity, protect the spine from compressive damage, until the epiphyseal plate matures. The method of long-term bed rest in plaster casts has been rarely used in the past. If the disease is obvious at the initial onset, consider using plaster bed or plaster vest for fixation for 2 to 3 months, and then use a brace and exercise the back muscles. If the child is painless, treatment can be determined according to the deformity; when the kyphotic deformity is less than 45 to 50°, only corrective exercises are needed; when it is between 50 to 80°, it is necessary to use a brace for fixation and add back muscle training. A few patients have a significant hunchback, affecting appearance and requiring spinal correction and fusion surgery. Occasionally, there may be symptoms of spinal cord compression requiring decompression.