Adolescent Lumbar Intervertebral Disc Herniation: Causes, Diagnosis and Treatment

Main Article Content

Mahmoud El-Qadi, Mohamed A. Thabit, Ehab Mohamed Eissa, Alaa Abdel Fattah Abdel Aziz, Ramy Kamel

Abstract

Background:


Lumbar disc herniation in adolescents is a relatively rare condition among those cases presented with low back pain. Trauma & genetics are the commonest predisposing factors in adolescent lumbar disc herniation. The clinical presentations of disc herniation in adolescents differ from those of the adults. Back pain is not all marked in adolescent patients.


Objective:


 this study was subjected to discuss the etiology, diagnosis and treatment modalities and the variable outcomes for both medical and surgical treatment of lumbar disc herniation in adolescents.


 


Patients and Methods:


This prospective study was conducted on twenty patients between 10 and 19 years old presenting with lumbar disc herniation, managed and treated conservatively and/or surgically in Neurosurgery Department at Kasr Al Ainy School of medicine, Cairo University in the period from October 2015 to September 2016 with 12 months follow-up period.


 


Results:


in our study the peak incidence was between 17 and 19 years old (83.3% of males and 75% of females. Most of patients in our study were males (12 patients, 60%) with male: female ratio 1.5: 1. Twelve patients (60%) gave a positive family history, also 9 cases (45%) had a history of back trauma prior to affection with lumbar disc herniation. All the cases (100%) were presented with sciatic pain while only half of them had low back pain, Also 2 cases were presented with motor deficit. After performing MRI of lumbosacral spine (investigation of choice) for the patients, L5-S1 disc level was the most common level affected (50% of cases). All the patients were subjected to medical treatment which was effective in 40% of the cases and surgical treatment was the only curative method in 12 cases (60%). Half of the operated patients (6 patients) underwent conventional open laminectomy and discectomy with foraminotomy, 6 patients were operated upon using micro-discectomy with foraminotomy. In our study, the outcome was excellent in 90% of cases as they had significant to complete relief of pain and significant improvement in the neurological deficits was achieved. While 10% of cases had moderate relief of pain and continued on some medical treatment.


Conclusion:


Lumbar disc herniation in adolescents is not as common as in adults but it's thought to be increasing in the society and it is mostly due to trauma. Diagnosis to a large extent is similar to adults. Conservative treatment is less effective for adolescent patients as compared with adults, even though it remains the first-line treatment for adolescent LDH. Proper selection of the surgical cases with the appropriate intervention is associated with good to excellent outcome.

Article Details

How to Cite
Mahmoud El-Qadi, Mohamed A. Thabit, Ehab Mohamed Eissa, Alaa Abdel Fattah Abdel Aziz, Ramy Kamel. (2022). Adolescent Lumbar Intervertebral Disc Herniation: Causes, Diagnosis and Treatment. Annals of the Romanian Society for Cell Biology, 26(01), 2733 – 2749. Retrieved from https://annalsofrscb.ro/index.php/journal/article/view/11234
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