Related Experiment Video

Updated: May 27, 2026

Intraoperative Ultrasound in Spinal Surgery
05:53

Intraoperative Ultrasound in Spinal Surgery

Published on: August 17, 2022

Pediatric disk herniation

William F Lavelle1, Aaron Bianco, Robert Mason

  • 1Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|November 5, 2011
PubMed

Insights

Pediatric disk herniation, a rare cause of back pain in children, often has delayed diagnosis. While surgery is sometimes needed, initial non-surgical treatments are recommended for isolated pain and normal exams.

Area of Science:

  • Pediatric Orthopedics
  • Neurosurgery
  • Spinal Surgery

Background:

  • Pediatric disk herniation is an uncommon condition presenting as back or radiating leg pain in children.
  • Delayed diagnosis is common due to its rarity compared to adult disk herniation.
  • Apophyseal fractures are present in 28% of adolescent cases, influencing treatment decisions.

Purpose of the Study:

  • To review the diagnosis and management of pediatric disk herniation.
  • To highlight the differences in presentation and treatment compared to adult disk herniation.
  • To assess the efficacy of surgical and non-surgical interventions.

Main Methods:

  • Review of pediatric disk herniation cases.
  • Analysis of diagnostic delays.
  • Evaluation of treatment outcomes for surgical and non-surgical approaches.
  • Comparison of herniations with and without apophyseal fractures.

Main Results:

  • Non-surgical care is recommended for isolated pain with normal neurological exams.
  • Surgical intervention is more frequent in cases involving apophyseal fractures.
  • Laminotomy and fragment excision are standard surgical procedures.
  • Short-term pain relief is excellent post-surgery, with a 1% reoperation rate in the first year.

Conclusions:

  • Pediatric disk herniation requires consideration in pediatric back pain differentials.
  • Non-surgical management should be attempted first for specific patient profiles.
  • Surgical outcomes are generally positive in the short term, but long-term reoperation rates are significant (20-30%).

Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
Degenerative Disc Disease ll: Pathophysiology01:23

Degenerative Disc Disease ll: Pathophysiology

The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
Degenerative Disc Disease I: Introduction01:27

Degenerative Disc Disease I: Introduction

Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...