Lumbar disc excision in children and adolescents.
METHODS
The authors examined a case series of patients under the age of 18 years treated for lumbar intervertebral disc herniation.


OBJECTIVE
To evaluate postoperative and long-term results of surgery in patients younger than 18 years.


BACKGROUND
There are only a few series, with controversial results, available on the surgical treatment of disc herniation in growing patients.


METHODS
Between 1975 and 1991, a consecutive series of 129 patients 9-18 years of age (average age, 16.2 years) underwent surgery for lumbar intervertebral disc herniation. Low back pain associated with leg pain was the main clinical symptom in 106 subjects (82%), back pain in 17 (13%), and leg pain in 6 (5%).


RESULTS
Short-term results were excellent or good for 123 cases (95%), with complete pain relief in 97 (75%) and moderate but incomplete relief in 26 (20%). A total of 98 (76%) long-term responses obtained at a mean follow-up of 12.4 years revealed excellent outcomes in 40% of the cases, good in 47%, and poor in 13%. Ten patients (10%) underwent reintervention after 9 years on average (2 fusions and 8 re-explorations for herniated disc).


CONCLUSIONS
Results have confirmed a tendency for outcomes to deteriorate between the short-term and long-term follow-up in young patients treated by discectomy: this tendency and the rate of reintervention (10%) confirmed the need for long-term follow-up of children and adolescents treated for disc herniation.
Parisini
P
P
Department of Spine Surgery, Rizzoli Orthopedic Institute, Bologna, Italy. parisini.p@tiscalinet.it
Di Silvestre
M
M
Greggi
T
T
Miglietta
A
A
Paderni
S
S
D000293:Adolescent; D002648:Child; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D012585:Sciatica / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome