title: Surgical excision of the lumbar disc herniation in elementary school age.
abstract: METHODS
  A retrospective study.
  
  
  OBJECTIVE
  To assess the radiological, clinical features and surgical outcomes of six patients of elementary school age with lumbar disc herniation (LDH).
  
  
  BACKGROUND
  LDH is common in people in their fourth and fifth decades. However, the condition is extremely rare in children of elementary school age. Moreover, the clinical symptoms and treatments are different from those of adults.
  
  
  METHODS
  We reviewed a series of 6 patients under the age of 12 years, who underwent surgery for LDH at our institution between 1992-2002. Initially, all patients were treated conservatively. The indications for surgery were failure of conservative treatment for 3 months, intractable pain and/or progressive neurological impairment.
  
  
  RESULTS
  The surgical findings revealed a protruding disc in five cases and a ruptured disc in one. In addition, separation of the vertebral ring apophysis was observed in 3 cases. The symptoms had disappeared completely at the last follow-up. At the last follow-up, the Japanese Orthopaedic Association score was 10 points in 5 cases and 9 points in 1, and the Kirkaldy-Willis criteria was excellent in all patients. No intervertebral disc space narrowing was observed in any patient at last follow up. In addition, there were no degenerative changes in the vertebral endplate and facet joint.
  
  
  CONCLUSIONS
  Patients with symptoms that persist for more than 3 months or those with a progressive neurological deficit must be considered for surgical discectomy.
authors.affiliation: Department of Orthopedic Surgery, Holy Family Hospital, The Catholic University of Korea, Bucheon, Korea.
authors.forename: Youn-Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Il-Jung
authors.initials: IJ
authors.lastname: Park
authors.forename: Kee-Won
authors.initials: KW
authors.lastname: Rhyu
authors.forename: Sang-Uk
authors.initials: SU
authors.lastname: Lee
authors.forename: Changhoon
authors.initials: C
authors.lastname: Jeong
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