Minimally invasive high-definition microscope assisted small channel treatment of lumbar disc herniation in children: a case report

Abstract

Background: Despite lumbar disc herniation (LDH) is common in adults, it is extremely rare in children. The treatment of LDH in children is still a challenge for surgeons. This study aimed to explore the pathogenesis, clinical characteristics and treatment methods of LDH in children for communication and learning.Methods: In October 2017, a child with LDH who failed to receive conservative treatment underwent surgical treatment. The child underwent minimally invasive high-definition microscope-assisted nucleus pulposus resection and nerve root decompression. The soft tissues such as muscles and paravertebral ligaments were separated and removed under microscope, the nucleus pulposus of disc herniation was removed, and the left lumbar 5 nerve root was decompressed. During the short-term and long-term follow-up after operation, the assessment pain was significantly improved, the activity was not limited, and the muscle strength returned to normal.Results: The next day after operation, the child could wear ordinary waist circumference to get out of bed, and the left lower limb muscle strength returned to grade 4-5, and were discharged 5 days after operation. After 3 years of telephone follow-up, the patient complained that the pain was significantly relieved, the left lower limb movement was not limited, and the muscle strength returned to normal. Conclusions: In this case, the minimally invasive high-definition microscope assisted small channel treatment of LDH in children was successful, and the postoperative recovery was good. It can provide reference for LDH in children who need surgical treatment when conservative treatment was ineffective.