A review of current treatment for lumbar disc herniation in children and adolescents

Eur Spine J. 2010 Feb;19(2):205-14. doi: 10.1007/s00586-009-1202-7. Epub 2009 Nov 5.

Abstract

Lumbar disc herniation (LDH) is a common disorder among adults with degenerated lumbar intervertebral discs. However, its occurrence in childhood and adolescence is much less frequent mostly because children and adolescents tend to have a healthier lumbar spine as compared with adults. This difference indicates that children and adolescents are far from being just little adults. Over the years, there have constantly been published studies concerning this entity where the findings suggested that pediatric LDH is, in many ways, different from that in adults. To date, the prevalence, the etiological and the diagnostic features of pediatric LDH have been fully described in the literature whereas the characteristics regarding to the treatment is yet to be reviewed in details. The aim of the present review is to provide a collective opinion on the treatment of pediatric LDH as well as its outcome. It reviewed the relevant information available in the literature and compared the results among and within various treatments. It was found that pediatric patients responded less favorably to conservative treatment as compared with adults. In addition, the outcome of surgery remained to be satisfactory for at least 10 years after the initial operation, even though it appeared to deteriorate slightly. To the best of our knowledge, this is the first literature review focusing on the treatment of pediatric LDH.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Bed Rest / statistics & numerical data
  • Child
  • Combined Modality Therapy / methods
  • Combined Modality Therapy / statistics & numerical data
  • Diskectomy / methods
  • Diskectomy / statistics & numerical data
  • Humans
  • Intervertebral Disc / growth & development
  • Intervertebral Disc / pathology
  • Intervertebral Disc / surgery*
  • Intervertebral Disc Chemolysis / statistics & numerical data
  • Intervertebral Disc Displacement / pathology
  • Intervertebral Disc Displacement / physiopathology
  • Intervertebral Disc Displacement / therapy*
  • Lumbar Vertebrae / growth & development*
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery*
  • Spinal Fusion / adverse effects
  • Spinal Fusion / statistics & numerical data
  • Spondylosis / pathology
  • Spondylosis / therapy*