方法:回顾性文献回顾分析目的:分析危险因素,特点,结果,≤15岁儿童椎间盘突出症的手术治疗和随访(y.O)通过文献回顾。
背景:椎间盘突出症是儿科人群中的一种罕见疾病。虽然保守治疗如果经常尝试,有些病例需要手术治疗。
方法:使用PubMed数据库以术语“小儿/儿童/青少年椎间盘突出症”和“手术管理”作为关键词进行文献检索。重要手稿,即:病例报告,案例系列,审查进行了识别和分析。排除标准为:患者>15岁的系列和病例,结果不可个性化和医疗管理。
结果:确定了49项研究,28人被保留。69名<15岁的儿童被确定为中位年龄为13岁(SD1-15)。平均FU为3.3年。创伤和反复的微创伤被确定为该人群椎间盘突出的主要原因。它主要是一种腰椎疾病,描述了非常严重的胸或颈疝病例。在没有神经缺陷的情况下,应尝试保守治疗。存在不同类型的手术(开放性,内窥镜,管状),结果或并发症无差异。术后结果非常令人满意,没有神经后遗症,恢复良好。
结论:小儿椎间盘突出通常是由创伤等诱发因素引起的。在没有保守治疗的情况下,手术方案可产生良好的短期临床结局,并发症少,无神经系统后遗症.
METHODS: Retrospective literature review analysis OBJECTIVE: Analyze the risk factors, characteristics, outcome, and follow up of surgical management of disc
herniation in children ≤15 years old (y.o) through a review of the literature.
BACKGROUND: Disc
herniation is a rare disease in the pediatric population. While conservative treatment if very often tried, some cases require surgical treatment.
METHODS: A literature search was conducted using PubMed data base using the terms \'pediatric/children/adolescent disc herniation\' and \'surgical management\' as key words. Significant manuscripts i.e: case reports, case series, reviews were identified and analyzed. The exclusion criteria were: series and cases with patients >15 y.o, results non-individualizable and medical management.
RESULTS: 49 studies were identified, 28 were retained. 69 children <15 y.o were identified with a median age of 13 y.o (SD 1-15). The mean FU was 3.3 years. Trauma and repeated micro traumatism were identified as the main causes of disc
herniation in this population. It is mostly a lumbar disease, with very anecdotic cases of thoracic or cervical
herniation described. In the absence of neurological deficit, conservative treatment should be tried. Different types of surgery exist (open, endoscopic, tubular), with no difference in outcome or complications. The post-operative outcome was very satisfactory, with no neurological sequalae described with excellent recovery.
CONCLUSIONS: Pediatric disc
herniation is often caused by precipitating factors such as trauma. In the absence of resolution with conservative treatment, surgical options yield favorable short term clinical outcomes with minimal complications and no neurological sequalae.