The Journal of Bone and Joint Surgery, Vol 64, Issue 7 991-996, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
Lumbar disc excision in children and adolescents
JK DeOrio and AJ Bianco
Fifty patients, all of whom were sixteen years old or younger, underwent
discectomy for a herniated lumbar disc at the Mayo Clinic between 1950 and
1976. Ninety-four per cent of the patients had had excellent or good
initial relief of symptoms after the initial operation. Subsequently,
however, twenty-eight of the thirty-seven patients who initially had
undergone disc excision only required additional treatment for low-back
pain or sciatica. Twelve of them required a second operation, consisting of
nine discectomies (six with a concomitant spine fusion), two spine fusions
alone, and one re-fusion. Of the thirty-seven patients who initially had
had disc excision alone, three had a recurrent disc protrusion and five had
a disc protrusion at another level. Of sixteen patients who had had
multiple subtotal hemilaminectomies at the initial operation, either for
involvement of multiple discs or for exploration, seven required
reoperation. In the twelve patients who had had both a disc excision and a
lumbar spine fusion as the initial operation, there were no recurrent disc
protrusions and only one patient had a protrusion at another level.
Follow-up on all patients ranged from five to thirty years (average,
nineteen years). Ninety per cent of the patients stated that the condition
of the back had little or no effect on their current way of life, despite
the presence of continuing back complaints in some. However, we rated the
results of the initial discectomy at follow-up as excellent or good in 73.5
per cent and poor in 26.5 per cent of the patients.
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