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Lumbar disc excision in children and adolescents
P Parisini1, M Di Silvestre, T Greggi
1Department of Spine Surgery, Rizzoli Orthopedic Institute, Bologna, Italy. parisini.p@tiscalinet.it
Study Design:
The authors examined a case series of patients under the age of 18 years treated for lumbar intervertebral disc herniation.
Objectives:
To evaluate postoperative and long-term results of surgery in patients younger than 18 years.
Summary Of Background Data:
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.