title: Pediatric disk herniation.
abstract: Pediatric disk herniation is a rare condition that should be considered in the differential diagnosis of the child with back pain or radiating leg pain. Because pediatric disk herniation is relatively uncommon, there is typically a delay in diagnosis compared with time to diagnosis of adult disk herniation. Pediatric disk herniations are often recalcitrant to nonsurgical care, but such measures should be attempted in patients who present with isolated pain symptoms and have a normal neurologic examination. Twenty-eight percent of adolescent disk herniations involve apophyseal fractures; this presentation has a higher rate of surgical intervention than do herniations without fracture. Surgical management of pediatric disk herniation involves laminotomy and fragment excision. Short-term data demonstrate excellent pain relief, with 1% of children requiring repeat surgery for lumbar disk pathology in the first year. Long-term data suggest that 20% to 30% of patients will require additional surgery later in life.
authors: Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, USA.
authors: William F
authors: WF
authors: Lavelle
authors: Aaron
authors: A
authors: Bianco
authors: Robert
authors: R
authors: Mason
authors: Randal R
authors: RR
authors: Betz
authors: Stephen A
authors: SA
authors: Albanese
mesh_terms: D002648:Child; D003937:Diagnosis, Differential; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D007796:Laminectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D010808:Physical Examination; D011379:Prognosis; D012307:Risk Factors