КОМПЛЕКСНАЯ ОЦЕНКА ВЕРТЕБРОГЕННЫХ БОЛЕВЫХ СИНДРОМОВ У ДЕТЕЙ С УЧЁТОМ ФАКТОРОВ РИСКА И ТЕРАПЕВТИЧЕСКИХ ПОДХОДОВ

Abstract

Background. Spinal pain syndromes in children and adolescents represent an important clinical problem characterized by multifactorial etiology, age-dependent manifestations, and the potential development of persistent pain-related disability. Contemporary approaches increasingly recognize the interaction of biomechanical, neurophysiological, psychological, and social factors rather than attributing all spinal pain to structural abnormalities. Distinguishing nonspecific musculoskeletal pain from vertebral pathology, inflammatory disease, and neurological compression remains a major diagnostic challenge.

Materials and Methods. A narrative analytical review of international guidelines, clinical investigations, systematic reviews, and meta-analyses was conducted. The analysis focused on epidemiology, clinical phenotypes, neurological examination, diagnostic imaging, functional assessment, and conservative therapeutic strategies for spinal pain in children and adolescents.

Results. Major biomechanical, constitutional, neurophysiological, behavioral, and psychosocial factors associated with pediatric spinal pain were systematically characterized. Comparative diagnostic and therapeutic tables were developed. An original conceptual framework, PED-SPINE-PAIN, was proposed to integrate pain characteristics, neurological findings, functional limitations, clinical warning signs, and individual risk factors.

Conclusion. Comprehensive assessment of pediatric spinal pain requires differentiation between specific and nonspecific conditions, early identification of potentially serious pathology, and systematic evaluation of functional disability. In the absence of clinical warning signs, therapeutic exercise, restoration of physical activity, patient education, and individualized rehabilitation represent central components of management.