Efficacy of percutaneous endoscopic lumbar discectomy for pediatric
lumbar disc herniation and degeneration on magnetic resonance imaging: case
series and literature review

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Objective

Pediatric lumbar disc herniation (LDH), although uncommon, causes significant pain, discomfort, and sometimes disability. We examined the efficacy of percutaneous endoscopic lumbar discectomy (PELD) for pediatric LDH and the degree of lumbar disc degeneration at 1 year after PELD.

Methods

We retrospectively reviewed the data of pediatric patients with LDH who underwent PELD from December 2007 to July 2018. The patients’ symptoms, physical examination findings, clinical images, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), and perioperative results (blood loss, length of hospital stay, and complications) were obtained from the medical records. Lumbar disc degeneration was graded using the modified Pfirrmann grading system at the 1-year postoperative magnetic resonance imaging (MRI) examination.

Results

Six boys and four girls who underwent PELD were evaluated. The patients’ mean age was 15.6 years (range, 13–17 years). The mean VAS score for low back pain, mean VAS score for lower limb pain, and mean ODI preoperatively and 1 year postoperatively were 6.2 and 0.3, 6.9 and 0.5, and 20 and 0.1, respectively. MRI showed significant disc degeneration after PELD.

Conclusions

Treating pediatric LDH with PELD is safe and effective. It relieves pain and reduces disability. However, lumbar disc degeneration still occurs.

Related collections

Most cited references 23

Record: found
Abstract: found
Article: not found

Modified Pfirrmann grading system for lumbar intervertebral disc degeneration.

Fan Wang, Ping-Chung Leung, Kai Chow Choi … (2007)

A reliability study was conducted. OBJECTIVE.: To modify a grading system for lumbar disc degeneration and to test the reliability of this modified grading system. The 5-level Pfirrmann grading system for disc degeneration did not prove discriminatory when used to assess disc degeneration in the elderly spine. Such discriminatory power is necessary to test the association between other variables and severity of disc degeneration. An 8-level modified grading system for lumbar disc degeneration was developed including a description of the changes expected for each grade and a 24-image reference panel. The reliability of the modified grading system was tested on 260 lumbar intervertebral discs in 52 subjects (26 men, 26 female) with a mean age of 73 years (range, 67-83 years). All examinations were analyzed independently by 3 readers. Intraobserver and interobserver reliabilities were assessed by calculating weighted kappa statistics. On average, for all 3 readers, 0.39% of the 260 discs were classified as Grade 2, 22% were classified as Grade 3, 21.5% were classified as Grade 4, 25.3% were classified as Grade 5, 19.1% were classified as Grade 6, 7.1% were classified as Grade 7, and 4.8% were classified as Grade 8. Intraobserver agreement was excellent (weighted kappa range, 0.79-0.91) with substantial interobserver agreement (weighted kappa range, 0.65-0.67). Complete intraobserver agreement was obtained, on average, in 85% of all discs with 84% of disagreement being as a result of a 1 grade difference. Complete interobserver agreement was obtained, on average, in 66% of all discs with 91% of disagreement being as a result of a 1 grade difference. The modified Pfirrmann grading system is useful at discriminating severity of disc degeneration in elderly subjects. The system can be applied with good intra- and interobserver agreement.

0 comments Cited 137 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Lumbar Disc Herniation

Raj Amin, Nicholas Andrade, Brian Neuman (2017)

Substantial advancements have been made in the cause, diagnosis, imaging, and treatment options available for patients with lumbar disc herniation (LDH). We examined the current evidence and highlight the concepts on the frontline of discovery in LDH.

0 comments Cited 86 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Genetic Alterations in Intervertebral Disc Disease

Nikolay L Martirosyan, Arpan Patel, Alessandro Carotenuto … (2016)

Background Intervertebral disc degeneration (IVDD) is considered a multifactorial disease that is influenced by both environmental and genetic factors. The last two decades of research strongly demonstrate that genetic factors contribute about 75% of the IVDD etiology. Recent total genome sequencing studies have shed light on the various single-nucleotide polymorphisms (SNPs) that are associated with IVDD. Aim This review presents comprehensive and updated information about the diversity of genetic factors in the inflammatory, degradative, homeostatic, and structural systems involved in the IVDD. An organized collection of information is provided regarding genetic polymorphisms that have been identified to influence the risk of developing IVDD. Understanding the proteins and signaling systems involved in IVDD can lead to improved understanding and targeting of therapeutics. Materials and methods An electronic literature search was performed using the National Library of Medicine for publications using the keywords genetics of IVDD, lumbar disc degeneration, degenerative disc disease, polymorphisms, SNPs, and disc disease. The articles were then screened based on inclusion criteria that included topics that covered the correlation of SNPs with developing IVDD. Sixty-five articles were identified as containing relevant information. Articles were excluded if they investigated lower back pain or just disc herniation without an analysis of disc degeneration. This study focuses on the chronic degeneration of IVDs. Results Various genes were identified to contain SNPs that influenced the risk of developing IVDD. Among these are genes contributing to structural proteins, such as COL1A1, COL9A3, COL9A3, COL11A1, and COL11A2, ACAN, and CHST3. Furthermore, various SNPs found in the vitamin-D receptor gene are also associated with IVDD. SNPs related to inflammatory cytokine imbalance are associated with IVDD, although some effects are limited by sex and certain populations. SNPs in genes that code for extracellular matrix-degrading enzymes, such as MMP-1, MMP-2, MMP-3, MMP-9, MMP-14, ADAMTS-4, and ADAMTS-5 are also associated with IVDD. Apoptosis-mediating genes, such as caspase 9 gene (CASP9), TRAIL, and death receptor 4 (DR4), as well as those for growth factors, such as growth differentiation factor 5 and VEGF, are identified to have polymorphisms that influence the risk of developing IVDD. Conclusion Within the last 10 years, countless new SNPs have been identified in genes previously unknown to be associated with IVDD. Furthermore, the last decade has also revealed new SNPs identified in genes already known to be involved with increased risk of developing IVDD. Improved understanding of the numerous genetic variants behind various pathophysiological elements of IVDD could help advance personalized care and pharmacotherapeutic strategies for patients suffering from IVDD in the future.

0 comments Cited 45 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): J Int Med Res

Journal ID (iso-abbrev): J Int Med Res

Journal ID (publisher-id): IMR

Journal ID (hwp): spimr

Title: The Journal of International Medical Research

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Print): 0300-0605

ISSN (Electronic): 1473-2300

Publication date (Electronic): 20 January 2021

Publication date Collection: January 2021

Volume: 49

Issue: 1

Electronic Location Identifier: 0300060520986685

Affiliations

[1 ]Department of Neurosurgery, Puli Branch, Ringgold 40293, universityTaichung Veterans General Hospital; , Puli Township, Nantou county

[2 ]Department of Radiology, Ringgold 40293, universityTaichung Veterans General Hospital; , Taichung

[3 ]School of Medicine, National Yang-Ming University, Taipei

[4 ]Functional Neurosurgery Division, Neurological Institute, Ringgold 40293, universityTaichung Veterans General Hospital; , Taichung

[5 ]Department of Medical Research, Neurological Institute, Ringgold 40293, universityTaichung Veterans General Hospital; , Taichung

[6 ]Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei

[7 ]Department of Sports Medicine, College of Health Care, Ringgold 38019, universityChina Medical University; , Taichung

[8 ]Department of Orthopedic Surgery, Ringgold 38019, universityChina Medical University; Hospital, China Medical University, Taichung

[9 ]Spine Center, Ringgold 38019, universityChina Medical University; Hospital, China Medical University, Taichung

[10 ]PhD Degree Program of Biomedical Science and Engineering, National Chiao Tung University, Hsinchu

[11 ]Department of Orthopedics, Ringgold 40293, universityTaichung Veterans General Hospital; , Taichung

[12 ]Department of Medicinal Botanicals and Health Applications, Da-Yeh University, Changhua County

[13 ]Institute of Biomedical Sciences, National Chung Hsing University, Taichung

[14 ]Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County

[15 ]College of Health, National Taichung University of Science and Technology, Taichung

Author notes

[*]Hsi-Kai Tsou, Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sec. 4, Taichung 40705, Taiwan. Email: tsouhsikai@ 123456gmail.com

Author information

Hsi-Kai Tsou https://orcid.org/0000-0001-9374-9923

Article

Publisher ID: 10.1177_0300060520986685

DOI: 10.1177/0300060520986685

PMC ID: 7829541

PubMed ID: 33472475

SO-VID: e48feeec-5dc2-43af-8568-1df166a8f0f3

License:

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 15 November 2020

Date accepted : 11 December 2020

Custom metadata

typesetter ts2

Keywords: pediatric,lumbar disc herniation,percutaneous endoscopic lumbar discectomy,disc degeneration,magnetic resonance imaging,case series,literature review

Data availability:

Keywords: pediatric, lumbar disc herniation, percutaneous endoscopic lumbar discectomy, disc degeneration, magnetic resonance imaging, case series, literature review

Efficacy of percutaneous endoscopic lumbar discectomy for pediatric lumbar disc herniation and degeneration on magnetic resonance imaging: case series and literature review

Read this article at

Abstract

Objective

Methods

Results

Conclusions

Related collections

Jaypee UN SDG 03

Most cited references 23

Modified Pfirrmann grading system for lumbar intervertebral disc degeneration.

Lumbar Disc Herniation

Genetic Alterations in Intervertebral Disc Disease

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 390

Cited by 3

Most referenced authors 241