Lumbar disc herniation in early childhood: case report and literature review

Martínez‐Lage, Juan F.; Fernández-Cornejo, Víctor; López, F.; Poza, Máximo

doi:10.1007/s00381-003-0720-6

Cited by 42 publications

(36 citation statements)

References 8 publications

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“…Since Wahren firstly reported a case of a disc herniation surgery in a 12 year-old boy, some single-case or series reports revealed the incidence varying from 1% to 5% in adolescent population [4,5]. Although genetic predisposition [6,7] and trauma [8,9] have been reported as causes of LDH in adolescents, the etiology remains an area of continuing debate. The clinical features of LDH in adolescents, characterized with broader spectrum of symptoms, are typically different from those in adults [10,11].…”

Section: Introductionmentioning

confidence: 99%

Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy

Zhu

Zhao

Wang

et al. 2011

BMC Musculoskelet Disord

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BackgroundThere have been few studies focusing on the curve pattern of scoliosis caused by lumbar disc herniation (LDH) in adolescents and the natural history of scoliosis after discectomy. The current study was carried out to identify the curve pattern of scoliosis and investigate the effect of posterior discectomy on the curve improvement in adolescents with LDH.MethodsThis review focused on a group of 26 adolescents with LDH who initially presented to our clinic for evaluation of scoliosis, followed by posterior discectomy between 2000 and 2009. Radiographic measurements included curve pattern, specific curve features, trunk shift, and sagittal profile. The correlation between the side of disc herniation and the direction of lumbosacral curve and the trunk shift was evaluated.ResultsA typical curve pattern was initially identified in all of the patients as a short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side. 23 of 26 patients (88.5%) had a trunk shift more than 2.0 cm away from the midline, showing a poor coronal balance. A relatively straight sagittal profile was noted in all the patients. 84.6% (22/26) patients had a disc herniation at the convex side of lumbosacral curve. Similarly, 73.1% (19/26) patients showed a trunk shift toward the opposite side of disc herniation. All of the patients had an marked curve improvement immediately after discectomy. In the 17 patients with a more than 2-year follow-up, only two had a residual lumbosacral curve greater than or equal to 20 degrees. The mean ODI improved from 21.4% before surgery to 7.3% at the final follow-up.ConclusionsA short lumbosacral curve accompanied with a long thoracic or thoracolumbar curve toward the opposite side, and a relatively straight sagittal profile have been noted in all the patients. The direction of lumbosacral curve and trunk shift was related to the side of disc herniation. A majority of patients have a small curve size while assosiated with a significant coronal imbalance. Earlier decompression can provide a greater opportunity for spontaneous correction of scoliosis.

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Section: Introductionmentioning

confidence: 99%

Scoliotic posture as the initial symptom in adolescents with lumbar disc herniation: its curve pattern and natural history after lumbar discectomy

Zhu

Zhao

Wang

et al. 2011

BMC Musculoskelet Disord

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“…After diagnosis, surgical excision is usually recommended and after that, the pain is alleviated in a short time, as in our patient [5]. If the pain persists, it usually suggests incomplete excision.…”

Section: Discussionmentioning

confidence: 81%

“…Although the clinical presentation of the patient which we reported was similar to that of patients with lumbar disc herniation, this entity has been accounted as being exceptionally below the age of 10 years and the magnetic resonance imaging scan did not confirm it [5]. …”

Section: Discussionmentioning

confidence: 96%

Sciatica in a Five-Year-Old Boy

2014

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The prevalence of back pain during childhood is 50%; in 22% of these cases, a specific diagnosis can be found. Osteoid osteoma is a rare benign tumor that occursonly in 20% of cases and involves the spine. The aim of this report is to explain an atypical case of lumbar osteoid osteoma with significant neurologic deficit at a very young age. A five-year-old boy was presented with refractory pain in the low back and left extremity for approximately one year. Positive clinical findings were antalgic gait, stiff lumbar spine, weak left big toe extension force and a positive straight leg rising test on the left side. Paraclinical studies revealed osteoid osteoma in the left-sided pedicle of the fifth lumbar vertebra. With surgical excision, he recovered immediately. Lumbar osteoid osteoma should be suspected as the cause of low back pain or sciatalgia in any young patient.

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“…Intervertebral disc herniation is less common in children than it is in adults, and because of the low level of suspicion among physicians, the diagnosis is usually delayed . One distinctive feature in the paediatric population is that up to 90% of patients have a positive straight leg raise test .…”

Section: Differential Diagnosismentioning

confidence: 99%