Retrospective Analysis Of Lumbar Disc Herniation In Child And Adolescents

Objective:To investigate the pathogenesis,clinical feature and alternative approach of lumbar disc herniation in child and adolescents.Methods:The clinical data of 34 inpatients(age 13～20tears,admitted in Xinxiang medical university first teaching hospital from 1995to2006)with lumber disc herniation were retrospectively reviewed.Among them,8 patients received conservative treatment and the others underwent operation,including interlanimar partial laminotomy(21 patients),hemi laminar laminotomy(2 patients),laminar laminotomy(2 patients),extraperitoneal anterolateral discectomy was performed one patient.All patients were follow-up for 1 to 11 years.Follow up evaluation were performed via clinical visits.The Japanese orthopedic associations evaluation system for lower back pain syndrome(JOA score) was used to evaluate the outcomes.Results:The lumber and leg pain was relieved in all patients after therapy.there was no deterioration of symptoms in the operative groups. During the follow-up,7 patients had low back pain occasionally,one patient in the non-operative group had numbness,there was no significant differences in JOA score before and after treatment in all groups(p＜0.05),the treatment results among each groups has no statistic difference.But the interlanimar partial laminotomy group symptoms relieved faster than others.Conclusions:The clinical presentation of lumbar disc herniation is significantly different between adults and teenagers.Symptoms of child and adolescent are slighter and signs are severer than those of adults.For diagnosis,signs and image changes are more reliable than symptoms;for treatment: conservative treatment is taken first,if no effects,operation should be performed as soon as possible.