Abstract
Objective. To analyze the features of surgical treatment of children and adolescents with herniated discs and radicular compression symptoms. Material and Methods . A retrospective multicenter study of 34 patients with juvenile osteochondrosis with mean age of 15.4 years was performed. Surgical treatment included disc puncture methods, microdiscectomy through posterior approach, anterior discectomy, dynamic and rigid stabilization, and replacement of the fibrous ring defect. Results . Positive clinical effect with complete relief of pain was achieved in all cases. Paretic syndrome regressed completely in all patients. All patients regained the level of physical activity in the next 2-3 months. Long-term follow-up was on average 45.5 months. No recurrence of pain was noted during the follow-up period. Conclusion . Surgical treatment of disc herniation in children results in the relief of pain and full functional recovery. Among surgical methods, a preference should be given to microdiscectomy through minimally invasive surgical approaches. In the presence of indications, both rigid stabilization of spinal motion segment at the level of decompression and dynamic stabilization can be performed, and the latter is more preferable.
Highlights
Учитывая относительно малое количество детей и подростков, нуждающихся в оперативном лечении по поводу грыж дисков поясничного отдела позвоночника и корешкового болевого синдрома, в данной статье объединен опыт трех клиник, специализированно занимающихся хирургией позвоночника
Хирургическое лечение грыжи межпозвонкового диска у детей приводит к отличному результату, с полным регрессом болевого синдрома, возвращением пациентов к привычному активному образу жизни
Summary
При оперативном лечении использовали дископункционные методы, микродискэктомию из дорсального доступа, переднюю дискэктомию, динамическую и ригидную стабилизацию, замещение дефекта фиброзного кольца. Оперативное лечение грыж дисков у детей приводит к купированию болевого синдрома и полному функциональному восстановлению. Для цитирования: Кулешов А.А., Крутько А.В., Исхаков О.С., Ветрилэ М.С., Абакиров М.Д., Пелеганчук А.В., Васильев А.И., Лисянский И.Н., Мещеряков С.В., Кокорев А.И. Surgical Treatment of Disc Herniation in Children and Adolescents A.A. Kuleshov, A.V. Krutko, О.S. Iskhakov, M.S. Vetrile, M.D. Abakirov, A.V. Peleganchuk, A.I. Vasilyev, I.N. Lisyansky, S.V. Meshcheryakov, A.I. Kokorev1 1Central Institute of Traumatology and Orthopaedics n.a. N.N. Priorov, Moscow, Russia; 2Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan, Novosibirsk, Russia; 3Institute of Emergency Pediatric Surgery and Traumatology, Moscow, Russia. Surgical treatment included disc puncture methods, microdiscectomy through posterior approach, anterior discectomy, dynamic and rigid stabilization, and replacement of the fibrous ring defect. Surgical treatment of disc herniation in children results in the relief of pain and full functional recovery.
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