Calvet’s disease is a disease of the spine in which aseptic necrosis of the body of one or more vertebrae occurs in the form of its deformation and a decrease in its height. The disease is named after the French surgeon J. Calvet, who first described it. The pathological process is most often localized in the thoracic spine, less often in the cervical and lumbar. The vertebral body is usually affected, although the arch, as well as the articular and transverse processes, can be affected. The mobility of the affected area is limited. Mostly the disease prevails among children.
Causes of Calve Disease
Calve’s disease can also be called osteochondropathy of the vertebral body. This disease is rare, mainly in children aged 2 to 15 years. Boys are more prone to illness than girls. The disease is quite slow, from 4 to 8 years. To date, Calve’s disease is classified into two types: genuinic (osteochondropathy) and symptomatic, radiologically detected platyspondylia, as a result of a pathological fracture of the vertebral body. Very often, Calvet’s disease is caused by an eosinophilic granuloma. In Gaucher disease, aneurysmal bone cyst, lymphogranulomatosis, osteochondropathy, aseptic necrosis of the vertebral body, acquired forms of Calvet’s disease are noted.
Symptoms of Calve Disease
The pathological process is mainly localized in the thoracic spine, although it can also in the cervical or lumbar. The disease can be manifested by back pain, which decreases in the supine position and increases with palpation and percussion in the affected area. As the disease develops, a person begins to feel tired in the back and fatigue quickly. Sometimes the first symptoms of the disease are pain in the affected area, in the first 3-7 days of the acute manifestation of the disease – an increase in body temperature to 39 ° C, as well as impaired functions of the spinal roots. During palpation, the patient has soreness, limited muscle tension and a slight button-shaped protrusion of the spinous process of the affected vertebra. Disturbed vertebral functions make its flexion and extension limited. Complication of Calvet’s disease is explicit Kyphosis. The clinical signs of the disease do not depend on the degree of destruction of the vertebral bodies.
Calve Disease Treatment
Treatment is usually conservative, prolonged, it can take from 3 to 5 years. The main therapy consists of unloading the spine, therapeutic exercises, as well as massage and general strengthening measures. For the first time, the patient is prescribed a bed rest and spinal reclamation is performed. Every half year it is necessary to carry out x-ray control. A flat vertebra can recover at 2/3 of its original height. After the height of the spine has been restored, it is permissible for a patient in a proppant corset to be in a cortical position. In cases where conservative treatment does not give the desired result and in the absence of a tendency to restore the function of the roots of the spinal cord, the patient is shown surgical intervention. During the operation, spinal reclinations are achieved with two compression brackets of the Tsivyan-Ramikh type, with fucusation behind the spinous processes of the flat vertebra. The main load is transferred to the posterior vertebrae, due to which the body of the flat vertebra is successfully restored. A month after the operation, the patient may be in an upright position in a plastic corset. But, unfortunately, the function and deformation of the affected spine cannot be completely corrected, therefore, such a patient may gradually develop osteochondrosis over the years.