LAUSR

OBJECTIVE There is a paucity of literature discussing associated risk factors, treatment options (including the use of minimally invasive surgery), and outcomes related to lumbar disc herniation (LDH) in children. We discuss risk factors for disc disease among pediatric patients and evaluate the efficacy of the minimally invasive approach. METHODS A retrospective review of pediatric patients with lumbar disc disease who underwent microdiscectomy at our institution between 2005 and 2016 was conducted. The pre-operative presentation, hospital course, post-operative course, and follow up (at least 3 years) were reviewed. We evaluated the risk factors for LDH as well as the surgical outcomes in both groups. RESULTS Fifty-two pediatric patients were surgically treated for LDH in our department between 2005 and 2016. Average age at surgery was 16.65 years. A total of 61 lumbar disc surgeries were performed: 48/61 (78.7%) employed the MISD approach and 13/61 (21.3%) were performed via OMD approach. The average BMI for all cases was 29.3. The average time to diagnosis was 7.9 months. Twenty-one cases (34.4%) were patients that were competitive athletes. Fifteen cases presented with LDH related to trauma (24.6%). In 46/61 cases there was complete resolution of symptoms at 1year follow-up visit (79.2% of MISD vs 61.5% OMD). CONCLUSION Similar risk factors to adult's LDH, such as elevated BMI, can be seen in the pediatric population. Yet, some unique risk factors such as post-traumatic LDH can be seen in this age group. Minimally invasive techniques are demonstrably safe and useful in this patient population.