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Lumbar Disc Herniation in Pediatric

DOI: 10.4236/ojmn.2018.82019, PP. 233-238

Keywords: Children, Lumbar Disc Herniation, Outcome

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Abstract:

Lumbar disc herniation is a common complaint among adults with degenerated lumbar intervertebral discs, however its incidence in childhood and adolescence is abundant. Findings recommended that pediatric lumbar disc herniation is dissimilar in numerous way from that in adults. It was confirmed that pediatric patients respond to conventional management less than adults, also the consequence of the operation continued to be acceptable for at least 10 years after the first surgery even though it seems to decline somewhat. This retrospective study was undertaken to determine the clinical outcome and the feature of lumbar disc prolapse in pediatric patients. 12 patients younger than 18 years were operated for lumbar disc prolapse in the period from 2012-2016. Patients preoperative data and radiological imaging, operative and postoperative follow up were reviewed. 12 patients were included in this study, 10 were male and 2 females, the average age was 15 years (ranging between 12 - 18 years). The average duration of the symptoms was 11 months. The average follow up was 14 months. All patients had a sciatica prior to surgery, 35% had motor deficit, and 60% had parasthesia. Conservative treatment failed in all patients. After surgery and follow up, improvement occurs in about 80% of patients, ranging from excellent to good, and 20% of patients with fair outcome. According to Pain Visual Analogue Scale, leg pain reduced from 90 - 30 and back pain from 80 - 35. Conclusion: Pediatric lumbar disc herniation is an uncommon object leading to hospitalization. About 0.1% - 0.2% of children and adolescence surgery for lumbar disc herniation in pediatric does not lead to chronic back pain or interfere with physical activity and is related to the excellent short consequence.

References

[1]  Revuelta, R., De Juambelz, P.P., Fernandez, B. and Flores, J.A. (2000) Lumbar Disc Herniation in a 27-Month-Old Child. Case Report. Journal of Neurosurgery, 92, 98-100.
[2]  Katz, J.N. (2006) Lumbar Disc Disorders and Low-Back Pain: Socioeconomic Factors and Consequences. The Journal of Bone and Joint Surgery. American Volume, 88, 21-24.
https://doi.org/10.2106/00004623-200604002-00005
[3]  Garcia-Cosamalon, J., del Valle, M.E., Calavia, M.G., Garcia-Suarez, O., Lopez-Muniz, A., Otero, J., et al. (2010) Intervertebral Disc, Sensory Nerves and Neurotrophins: Who Is Who in Discogenic Pain? Journal of Anatomy, 217, 1-15.
https://doi.org/10.1111/j.1469-7580.2010.01227.x
[4]  Martinez-Lage, J.F., Fernandez Cornejo, V., Lopez, F. and Poza, M. (2003) Lumbar Disc Herniation in Early Childhood: Case Report and Literature Review. Child’s Nervous System, 19, 258-260.
[5]  Luukkonen, K., Partanen, M. and Vapalaht, M. (1997) Lumbar Disc Herniations in Children: A Long-Term Clinical and Magnetic Resonance Imaging Follow-Up Study. British Journal of Neurosurgery, 11, 280-285.
https://doi.org/10.1080/02688699746041
[6]  MacGee, E.E. (1968) Protruded Lumbar Disc in a 9-Year-Old Boy. Journal of Pediatrics, 73, 418-419.
https://doi.org/10.1016/S0022-3476(68)80122-2
[7]  Carey, T.S., Garrett, J., Jackman, A., McLaughlin, C., Fryer, J. and Smucker, D.R. (1995) The Outcomes and Costs of Care for Acute Low Back Pain among Patients Seen by Primary Care Practitioners, Chiropractors, and Orthopedic Surgeons. The North Carolina Back Pain Project. The New England Journal of Medicine, 333, 913-917.
https://doi.org/10.1056/NEJM199510053331406
[8]  Durham, S.R., Sun, P.P. and Sutton, L.N. (2000) Surgically Treated Lumbar Disc Disease in the Pediatric Population: An Outcome Study. Journal of Neurosurgery, 92, 1-6.
[9]  Kurihara, A. and 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.
https://doi.org/10.1097/00007632-198009000-00009
[10]  Zamani, M.H. and MacEwen, G.D. (1982) Herniation of the Lumbar Disc in Children and Adolescents. Journal of Pediatric Orthopaedics, 2, 528-533.
https://doi.org/10.1097/01241398-198212000-00012
[11]  DeLuca, P.F., Mason, D.E., Weiand, R., Howard, R. and Bassett, GS. (1994) Excision of Herniated Nucleus Pulposus in Children and Adolescents. Journal of Pediatric Orthopaedics, 14, 318-322.
https://doi.org/10.1097/01241398-199405000-00008
[12]  Zhang, Y., Sun, Z., Liu, J. and Guo, X. (2008) Advances in Susceptibility Genetics of Intervertebral Degenerative Disc Disease. International Journal of Biological Sciences, 4, 283-290.
https://doi.org/10.7150/ijbs.4.283
[13]  Zucker, L., Amacher, A.L. and Eltomey, A. (1987) Juvenile Lumbar Discs. Child’s Nervous System, 3, 125-127.
https://doi.org/10.1007/BF00271141
[14]  Frymoyer, J.W., Pope, M.H., Clements, J.H., Wilder, D.G., MacPherson, B. and Ashikaga, T. (1983) Risk Factors in Low-Back Pain. An Epidemiological Survey. The Journal of Bone and Joint Surgery. American Volume, 65, 213-218.
https://doi.org/10.2106/00004623-198365020-00010
[15]  Shillito, J. (1996) Pediatric Lumbar Disc Surgery: 20 Patients under 15 Years of Age. Surgical Neurology, 46, 14-17.
https://doi.org/10.1016/0090-3019(96)00035-3
[16]  Pfirrmann, C.W., Metzdorf, A., Zanetti, M., Hodler, J and Boos, N. (2001) Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration. Spine, 26, 1873-1878.
https://doi.org/10.1097/00007632-200109010-00011
[17]  Shakeri, M., Yarandi, K.K., Haddadi, K. and Sayyahmelli, S. (2009) Prevalence of Abdominal Aortic Aneurysm by Magnetic Resonance Images (MRI) in Men over 50 Years with Low Back Pain. Rawal Medical Journal, 34, 1-3.
[18]  Zitting, P., Rantakallio, P. and Vanharanta, H. (1998) Cumulative Incidence of Lumbar Disc Diseases Leading to Hospitalization up to the Age of 28 Years. Spine, 23, 2337-2343.
https://doi.org/10.1097/00007632-199811010-00017

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