Paediatric lumbar disc herniation in the very young: A case-based update

Paediatric lumbar disc herniation in the very young: A case-based update

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Julian Cahill , Geoffrey Frost , Guirish A. Solanki
  • چاپ و سال / کشور: 2011

Description

Background A lumbar disc prolapse is commonly seen in the adult population and as a result, the signs and symptoms are well recognised and easily treated. A disc prolapse, in the adolescent and particularly the paediatric age group, is very rare indeed. The signs and symptoms are atypical in this age group, and there is often difficulty in recognising the pathology. This can lead to delays in the diagnosis and treatment of a very painful condition. Discussion Lumbar disc herniation in very young children can be hard to diagnose. There is limited information currently available in the literature on the topic of lumbar disc herniation in very young children. Overall, the surgical option in these children appears to have a favourable outcome. Illustrative case This case highlights an 18-month-old child who was not able to walk, following a fall. The child had a normal neurological examination and normal bladder and bowel function. A magnetic resonance imaging (MRI) scan of her lumbar sacral spine indicated a large right paracentral L4/5 disc prolapse indenting the right anterolateral margin of the thecal sac and abutting the right L5 nerve root. She subsequently underwent a laminoplasty and excision of a sub-ligamentous L4/5 disc prolapse under an operating microscope. Conclusions This case report highlights the problems in diagnosing an acute lumbar disc prolapse in an 18-month-old child and reviews the current literature dealing with an acute disc prolapse in very young children
Childs Nerv Syst (2011) 27:687–691 DOI 10.1007/s00381-010-1369-6 Received: 20 November 2010 / Accepted: 8 December 2010 / Published online: 18 January 2011
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