Abstract
Background
Lumbar disc herniation is mainly a disease of elderly people as degenerative changes progress with age.
Results and discussion
Present retrospective analysis was performed on 742 patients of lumbar disc disease operated over 11 years. Of 742 cases aged 20 years or less, 25 has been evaluated to see the clinical features, radiological features, operative findings, and outcome of lumbar disc surgery. The incidence of lumbar disc herniation in pediatric and adolescent populations was 3.5% (aged 20 years or less). All patients presented with low back pain with or without radiculopathy (n = 25). Diagnosis was easily made on magnetic resonance imaging. Gross degenerative changes in disc and end plates were uncommon (16%) in this population. The trauma may not be a predisposing factor in most of them. In 88% (n = 22) of the cases, only 1 level was affected; the commonest was L4–5 (n = 13). Disc herniation was centrolateral in 72% (n = 18) and central in 28% (n = 7). Disc was mostly soft, hydrated, and rubbery in 92% (n = 23). Disc herniation were subligamentous in 80% (n = 20) and extruded in 4% (n = 1). Sixteen percent (n = 4) of the patients had disc bulge with intact annulus.
Conclusions
Operative intervention in the form of simple discectomy offers good result in 92% (n = 23) cases irrespective of approach and method. Longer follow-up is mandatory because the chances of recurrence or another level involvement cannot be denied.
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References
Banerian KG, Wang AM, Samberg LC, Kerr HH, Wesolowski DP (1990) Association of vertebral end plate fracture with pediatric lumbar intervertebral disk herniation: value of CT and MR imaging. Radiology 177:763–765
Boos N, Weissbach S, Rohrbach H, Weiler C, Spratt KF, Nerlich AG (2002) Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine 27(23):2631–2644
Borgesen SE, Vang PS (1974) Herniation of the lumbar intervertebral disc in children and adolescents. Acta Orthop Scand 45:540–549
Bradbury N, Wilson LF, Mulholland RC (1996) Adolescent disc protrusions. A long-term follow-up of surgery compared to chymopapain. Spine 21(3):372–377
DeLuca PF, Mason DE, Weiand R, Howard R, Bassett GS (1994) Excision of herniated nucleus pulposus in children and adolescents. J Pediatr Orthop 14:318–322
DeOrio JK, Bianco AJ Jr (1982) Lumbar disc excision in children and adolescents. J Bone Joint Surg Am 64:991–996
Durham SR, Sun PP, Sutton LN (2000) Surgically treated lumbar disc disease in the pediatric population: an outcome study. J Neurosurg 92(1 Suppl):1–6
Ebersold MJ, Quast LM, Bianco AJ Jr (1987) Results of lumbar discectomy in the pediatric patient. J Neurosurg 67:643–647
Furnes O, Boe A, Sudmann E (1996) Lumbar intervertebral disk prolapse in adolescents. Tidsskr Nor Laegeforen 116(25):2993–2995 (Article in Norwegian)
Garrido E, Humphreys RP, Hendrick EB, Hoffman HJ (1978) Lumbar disc disease in children. Neurosurgery 2:22–26
Ishihara H, Matsui H, Hirano N, Tsuji H (1997) Lumbar intervertebral disc herniation in children less than 16 years of age. Long-term follow-up study of surgically managed cases. Spine 22:2044–2049
Kurihara A, Kataoka O (1980) Lumbar disc herniation in children and adolescents. A review of 70 operated cases and their minimum 5-year follow-up studies. Spine 5:443–451
Lee JY, Ernestus RI, Schröder R, Klug N (2000) Histological study of lumbar intervertebral disc herniation in adolescents. Acta Neurochir (Wien) 10:1107–1110
Mayer HM, Mellerowicz H, Dihlmann SW (1996) Endoscopic discectomy in pediatric and juvenile lumbar disc herniations. J Pediatr Orthop B 5(1):39–43
Papagelopoulos PJ, Shaughnessy WJ, Ebersold MJ, Bianco AJ Jr, Quast LM (1998) Long-term outcome of lumbar discectomy in children and adolescents sixteen years of age or younger. J Bone Joint Surg Am 80:689–698
Pietila TA, Stendel R, Kombos T, Ramsbacher J, Schulte T, Brock M (2001) Lumbar disc herniation in patients up to 25 years of age. Neurol Med Chir (Tokyo) 41(7):340–344
Raj Kumar, Kalra SK, Vaid VK (2007) Multiple factor analysis of prognosis in lumbar disc herniation and assessment of long-term outcome. Pan Arab Journal of Neurosurgery (in press)
Russwurm H, Bjerkreim I, Ronglan E (1978) Lumbar intervertebral disc herniation in the young. Acta Orthop Scand 49:158–163
Schindler OS, Fairbank JC (1996) Two-level intervertebral disc herniation in an adolescent. Br J Clin Pract 50(3):171–173
Shillito J Jr (1996) Pediatric lumbar disc surgery: 20 patients under 15 years of age. Surg Neurol 46(1):14–18
Villarejo-Ortega FJ, Torres Campa-Santamarina JM, Bencosme-Abinader JA, Alvarez-Sastre C, Pascual Martin-Gamero A, Perez-Diaz C, Cordobes-Tapia F, Gonzalez-Mediero I (2003) Lumbar disc disease in adolescents. Rev Neurol 36(6):514–517 (Article in Spanish)
Wahren H (1945) Herniated nucleus pulposus in a child of twelve years. Acta Orthop Scand 16:40–42
Yank IK, Bahk YW, Choi KH, Paik MW, Shinn KS (1994) Posterior lumbar apophyseal ring fractures: a report of 20 cases. Neuroradiology 36:453–455
Zamani MH, MacEwen GD (1982) Herniation of the lumbar disc in children and adolescents. J Pediatr Orthop 2:528–33
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Kumar, R., Kumar, V., Das, N.K. et al. Adolescent lumbar disc disease: findings and outcome. Childs Nerv Syst 23, 1295–1299 (2007). https://doi.org/10.1007/s00381-007-0370-1
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DOI: https://doi.org/10.1007/s00381-007-0370-1