Surgical management of lumbar disc herniation in children and adolescents

Raghu, Ashley L B; Wiggins, Anthony; Kandasamy, Jothy

doi:10.1016/j.clineuro.2019.105486

Cited by 25 publications

(25 citation statements)

References 65 publications

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“…LDH is a common disease in orthopedics. Due to the increase of sedentary office workers and learners in modern life, the LDH incidence rate is increasing year by year, with an emerging trend of the disease at younger ages [22]. At present, surgery is indicated in LDH patients if regular massage, traction, and other conservative treatment cannot alleviate waist and leg pain [23].…”

Section: Discussionmentioning

confidence: 99%

Prognosis Evaluation of MRI Combined with Magnetic Resonance Myelography on Lumbar Disc Herniation after Transforaminal Endoscopic Discectomy

Jiang

Zuo

Yuan

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. This study sets out to investigate the role of magnetic resonance imaging (MRI) combined with magnetic resonance myelography (MRM) in patients after percutaneous transforaminal endoscopic discectomy (PTED) and to evaluate its value in postoperative rehabilitation. Methods. The clinical date of 96 patients with lumbar disc herniation (LDH) after PTED was retrospectively analyzed. The enrolled patients were divided into MRI group ( n = 32 ) and MRI + MRM group ( n = 64 ) according to whether MRM was performed. The nerve root sleeve (morphology, deformation) and dural indentation, intervertebral space height (ISH), intervertebral space angle (ISA), degree of pain (Visual Analogue Scale (VAS)), vertebral function (Japanese Orthopaedic Association (JOA)), and long-term recurrence were compared between the two groups. Results. Compared with the MRI group, the MRI + MRM group better displayed nerve root morphology, sheath sleeve deformation, and dural indentation. Both MRI and MRI + MRM showed ISH and ISA changes well. Compared with the MRI group, the MRI + MRM group had a significantly lower VAS score for lumbar and leg pain, a significantly higher JOA score, and a significantly lower 2-year recurrence rate. Conclusion. MRM combined with MRI is more beneficial to improve the prognosis of LDH patients after PTED.

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Section: Discussionmentioning

confidence: 99%

Prognosis Evaluation of MRI Combined with Magnetic Resonance Myelography on Lumbar Disc Herniation after Transforaminal Endoscopic Discectomy

Jiang

Zuo

Yuan

et al. 2022

Computational and Mathematical Methods in Medicine

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“…However, the lower age limit has not been clearly de ned. Raghu et al [15] reported that LDH patients under 12 years of age were very rare, and the youngest patient in this study was a 10-year-old girl. BMI is one of the commonly used standards for measuring human body fat.…”

Section: Discussionmentioning

confidence: 49%

Evaluation of percutaneous endoscopic lumbar discectomy in treatment of obese adolescents with lumbar disc herniation：A retrospective study

Zhu

Liu

2021

Preprint

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Background: Obese patients are at risk of complications such as poor wound healing and increased infection rates after spinal surgery. Percutaneous endoscopic lumbar discectomy (PELD) has advantages over conventional open surgery in the treatment of obese adult patients with lumbar disc herniation (LDH) because it can decrease perioperative complications and enhance satisfaction degrees of patients. However, no clinical studies have evaluated the efficacy of PELD in obese adolescents with LDH. This study aimed to evaluate the efficacy of PELD in the treatment of obese ALDH.Methods: We retrospectively collected clinical data from 208 patients with single-segment ALDH who underwent PELD treatment in our hospital between January 2015 and December 2019. According to the body mass index classification standard of obesity for adolescents in our country, the patients were divided into obese and non-obese groups (control group). Based on the preoperative baseline data of the two groups, propensity score matching was performed to select patients from the two groups for the comparative study. Perioperative data included operative time, intraoperative blood loss and length of postoperative hospitalization. The visual analog scale (VAS), Oswestry disability index (ODI) and modified MacNab criteria were recorded as the main indicators of the surgical outcome, and the recurrence rate and incidence of complications were recorded as the minor indicators. Results: The obese and control groups included 45 patients each after 1:1 propensity score matching. Both groups showed improvements in VAS and ODI scores after surgery and at each follow-up time point (p < 0.05). However, there was no significant statistical difference in VAS and ODI scores between the two groups at each follow-up time point (p >0.05). In addition, the differences in operative time, intraoperative blood loss, length of postoperative hospitalization, incidence of complications, and recurrence rate were not statistically significant between the two groups (p >0.05). At the final follow-up, there was no significant difference in the excellent and good rate of MacNab classification between the two groups (p >0.05). Conclusion: PELD is a safe and effective minimally invasive technique for the treatment of obese patients with ALDH. The efficacy of PELD in obese and non-obese patients with ALDH was comparable.

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“…Lumbar disc herniation is a rare disease in children, and the cumulative incidence of disc herniation below 17 years is 4 in 10,000 [ 17 ]. Disc herniation findings were detected in four participants (33%) over 5 years, with a significantly higher incidence.…”

Section: Discussionmentioning

confidence: 99%

“…Disc herniation findings were detected in four participants (33%) over 5 years, with a significantly higher incidence. The development of disc degeneration or disc herniation in children is attributed to competition-level sports participation and lifestyle factors [ 17 ], and this could be the result of continued stress on disc degeneration. The most important finding of this study was that disc degeneration progressed from a young age in participants without LBP.…”

Section: Discussionmentioning

confidence: 99%

Incidence and temporal changes in lumbar degeneration and low back pain in child and adolescent weightlifters: A prospective 5-year cohort study

et al. 2022

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This study was conducted to investigate the incidence of lumbar degeneration findings and low back pain (LBP) in children and adolescent weightlifters using magnetic resonance imaging (MRI) and medical questionnaires over a 5-year period. Moreover, we aimed to reveal the temporal changes in the lumbar vertebrae caused by long-term weightlifting training during the growth period. Twelve children and adolescent weightlifters who participated in weightlifting for >2 years (six boys, six girls, 11.4±2.0 years) were enrolled. Participants underwent annual medical questionnaire surveys, including data on practice frequency, competition history, presence of LBP, and lumbar examinations using MRI during the 5-year follow-up. Lumbar disc degeneration was detected in all the participants after 4 years, and lumbar disc herniation findings were detected in 33% of participants after 5 years; one underwent herniotomy during the follow-up period. Lumbar spondylolysis was detected in 58% of patients at 5 years. Although there were three participants who had LBP in the final year, none had LBP that prevented them from returning to weightlifting. This 5-year cohort study of 12 children and adolescent weightlifters detected lumbar degeneration in all participants. High frequency weightlifting training over a long period during the growth period may increase the risk of developing current and future LBP.

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Surgical management of lumbar disc herniation in children and adolescents

Cited by 25 publications

References 65 publications

Prognosis Evaluation of MRI Combined with Magnetic Resonance Myelography on Lumbar Disc Herniation after Transforaminal Endoscopic Discectomy

Prognosis Evaluation of MRI Combined with Magnetic Resonance Myelography on Lumbar Disc Herniation after Transforaminal Endoscopic Discectomy

Evaluation of percutaneous endoscopic lumbar discectomy in treatment of obese adolescents with lumbar disc herniation：A retrospective study

Incidence and temporal changes in lumbar degeneration and low back pain in child and adolescent weightlifters: A prospective 5-year cohort study

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