title: Minimally invasive lumbar microdiscectomy in pediatric patients: a series of 6 patients.
abstract: OBJECTIVE
  Lumbar disc herniation is rare in the pediatric age group, but may still cause a significant amount of pain and disability. Whereas minimally invasive surgery (MIS) for lumbar disc herniation is routinely performed in adults, it has not yet been described in the pediatric population. The purpose of this study was to describe the surgical results of pediatric MIS-treated lumbar disc disease.
  
  
  METHODS
  The authors retrospectively reviewed a series of 6 consecutive cases of lumbar microdiscectomy performed using MIS techniques between April 2008 and July 2010. Presenting symptoms, physical examination findings, and preoperative MR imaging results were obtained from medical records. Perioperative results, including blood loss, length of hospital stay, and complications were assessed. Findings at latest follow-up evaluation were also recorded.
  
  
  RESULTS
  This report represents the first surgical series regarding pediatric lumbar microdiscectomies performed using MIS. The mean patient age was 16 years (range 14-17 years); there were 4 girls and 2 boys. Preoperative signs and symptoms of radiculopathic pain were notable in 100% of patients, and myotomal weakness was noted in 33% of patients. The first line of treatment in all patients was a period of conservative management lasting an average of 11.5 months (range 6-12 months). The mean intraoperative blood loss was 10.8 ml, and the mean postoperative length of stay was 1.3 days. There were no complications in this small series.
  
  
  CONCLUSIONS
  The treatment of pediatric lumbar disc herniation by using MIS techniques can be safe and efficacious. However, further study with a larger number of patients and longer follow-up is needed to compare outcomes between MIS and open microdiscectomies.
authors.affiliation: Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, 6621 Fannin Street, Houston, TX 77030, USA.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Thomas
authors.forename: Steven W
authors.initials: SW
authors.lastname: Hwang
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Curry
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Luerssen
authors.forename: Andrew
authors.initials: A
authors.lastname: Jea
mesh_terms: D000293:Adolescent; D017586:Diskectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome