Results of lumbar discectomy in the pediatric patient.

To determine the results of lumbar discectomy in pediatric patients, a review was conducted of the medical records of 74 consecutive patients (40 males and 34 females) younger than 17 years who underwent lumbar disc surgery between 1950 and 1983. During this period, only 3% of patients younger than 17 years who presented with the chief complaint of low-back pain eventually had lumbar disc operation. In 43 patients it was thought that an injury had precipitated the symptoms. Thirty-seven patients had a nerve deficit at the time of initial evaluation. Water-soluble contrast myelography with repeated postmyelographic computerized tomography is currently used to confirm the diagnosis. The disc operations were performed at the L4-5 level in 47% of patients, the L5-S1 level in 45%, the L3-4 and L4-5 level in 4%, and the L4-5 and L5-S1 level in 4%. Fourteen of the 74 patient underwent spinal fusion with their first operation. At 9 months postoperatively, 95% had good or excellent results. During an extended follow-up period of up to 34 years, 16 of the patients with early successful results required further back procedures. After all medical and surgical treatment in this group of patients, the results were excellent in 57%, good in 38%, and poor in only 4%.