Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Acta Paediatr. 2010 Jan;99(1):19-23. doi: 10.1111/j.1651-2227.2009.01460.x.
This article explores lumbar disc herniation in young children through focusing on matters relevant to patient presentation, physical examination, differential diagnosis, imaging and treatment.
Major databases were searched for studies that addressed lumbar disc herniation in young children.
Diagnosis of lumbar disc herniation in young children is usually delayed because of the rarity and lack of experience with this entity and the difficulty in extracting a reliable medical history. Nevertheless, lumbar disc herniation should be considered in the differential diagnosis of any young child presenting with a chief complaint of back pain and/or radiculopathy, especially in the setting of recent trauma. This should be coupled with a directed physical examination to elicit signs and narrow the differential diagnosis. Imaging studies, mainly magnetic resonance imaging, will help establish a diagnosis; yet radiographs are still required to exclude other spinal lesions. The initial management of lumbar disc herniation in children is the same as that in adults and consists of conservative treatment unless lumbar disc herniation affects the patient's motor and neurological functions in which case, early surgical treatment must be undertaken. Although the latter remains more difficult, current experience suggests a favourable outcome.
Awareness of lumbar disc herniation will help the paediatrician extract a relevant medical history, perform a directed physical examination, and order appropriate imaging studies. This will aid in initiating early intervention, be it conservative or operative, and achieving a favourable outcome.
本文通过关注与患者表现、体格检查、鉴别诊断、影像学和治疗相关的问题，探讨小儿腰椎间盘突出症。
主要数据库搜索了关于小儿腰椎间盘突出症的研究。
由于这种疾病的罕见性和缺乏经验，以及难以获取可靠的病史，小儿腰椎间盘突出症的诊断通常会被延误。然而，对于任何以腰痛和/或神经根病为主诉的年轻儿童，尤其是在近期外伤的情况下，应考虑将腰椎间盘突出症纳入鉴别诊断。这应与有针对性的体格检查相结合，以引出体征并缩小鉴别诊断范围。影像学研究，主要是磁共振成像，将有助于建立诊断；然而，仍需要拍摄 X 光片以排除其他脊柱病变。儿童腰椎间盘突出症的初始治疗与成人相同，包括保守治疗，除非腰椎间盘突出症影响患者的运动和神经功能，在这种情况下，必须早期进行手术治疗。虽然后者仍然更困难，但目前的经验表明预后良好。
了解腰椎间盘突出症将有助于儿科医生获取相关病史、进行有针对性的体格检查和安排适当的影像学检查。这将有助于早期干预，无论是保守治疗还是手术治疗，并实现良好的结果。
