Hanakita J, Suwa H, Nishihara K, Sakaida H, Iihara K
Department of Neurosurgery, Shizuoka General Hospital.
No Shinkei Geka. 1991 Apr;19(4):337-42.
Lumbar disc herniation is a rare occurrence in teenagers. There are several questions as to its pathogenesis, relationship to trauma, and clinical manifestations compared with those in adults. In the present paper, we described nine cases of teen-age lumbar disc herniation, which accounts for about 3.3% of all the operated lumbar disc herniations in our clinic. In the discussion, 687 cases of teen-age lumbar disc herniation were analyzed from the world literature. The clinical signs and symptoms in teenagers showed no distinct difference from those in adults. Laségue's sign was found in nearly all the patients. Although direct or indirect trauma to the lumbar region may play an important role in causing disc herniation in teenagers, a more important factor seems to be the degeneration of the disc material, which begins in children earlier than usually suspected. Although surgical therapy has been advocated by many authors, it must be followed up for a long term before the efficacy of such treatment for teenagers can be confidently ascertained.
青少年腰椎间盘突出症较为罕见。关于其发病机制、与创伤的关系以及与成人相比的临床表现，存在若干问题。在本文中，我们描述了9例青少年腰椎间盘突出症病例，约占我们诊所所有接受手术的腰椎间盘突出症病例的3.3%。在讨论中，我们从世界文献中分析了687例青少年腰椎间盘突出症病例。青少年的临床体征和症状与成人并无明显差异。几乎所有患者均出现直腿抬高试验阳性。虽然腰部的直接或间接创伤可能在青少年椎间盘突出症的发病中起重要作用，但一个更重要的因素似乎是椎间盘组织的退变，这种退变在儿童期开始的时间比通常认为的更早。尽管许多作者主张手术治疗，但在能够确定这种治疗方法对青少年的疗效之前，必须进行长期随访。
