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Orthogate
1089 Spadina Road
Toronto, AL M5N 2M7
Ph: 416-483-2654
Fax: 416-483-2654
christian@orthogate.com






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Our 12-year-old son hurt his back playing soccer. Turns out he has a herniated disc that isn't responding to steroid injections or physical therapy. He's scheduled for surgery to remove the disc and now our questions begin: how well does this work? How soon will he be able to get back into the game? Will he be doomed to have back problems the rest of his life?

Disc herniation in children is rare because the discs are strong with no age-related deterioration. When damaged by trauma such as a sports injury, new bone growth surrounds the disc to protect it. But sometimes the disc continues to protrude enough to compress the spinal cord or spinal nerve roots causing painful back and/or leg symptoms (sciatica). Conservative care such as your son has had with epidural steroid injections (ESIs) often relieve the painful symptoms enough that they can go to physical therapy and recover. But for those with intractable leg pain, surgery is advised before permanent nerve damage occurs. Since the number of children with disc herniations is low and the majority respond well to nonoperative care, there aren't a lot of studies and statistics to share about those who do have surgery. There is a recent study from Children's Hospital Boston looking at the results of 87 pediatric patients who had microdiscectomies to remove the herniated disc. The procedure was successful and the reported results good. Complications such as infection, neurologic symptoms, and cerebrospinal fluid leakage from this procedure were few and far between. In fact, only one per cent of the group had any problems of this sort. A few more (six per cent) ended up having a second surgery because not all of the disc material was removed the first time causing further painful symptoms. Despite the unique challenges to microdiscectomy in children, the procedure is safe and effective in this age group. Almost all of the 87 children in this particular study were pain free and able to return to their regular activities including sports eight to 12 weeks after surgery. The authors predicted that these early disc problems will NOT put the children at risk for future back problems but this remains to be seen. The children will be followed into adulthood and long-term results studied.

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