The experience of surgical treatment of lumbar disc herniation in adolescents using annuloplasty: Analysis of a small clinical series

Abstract

Objective. To assess feasibility, safety and effectiveness of a device for annular defect closure in surgical elimination of radicular compression syndrome in adolescents with degenerative disc disease. Material and Methods. Five 11-17-year-old patients underwent disc hernia removal and root decompression followed by annuloplasty with a Barricaid implant in 2012-2016. Clinical and radiological (CT, MRI) techniques were used to assess the pain intensity on VAS, the degree of intervertebral disk degeneration according to Pfirrmann, the orientation of the facet joints and the cartilaginous surface, and the severity of sclerosis. The long-term follow-up period averaged 57 months (from 40 to 62 months). Surgical results were evaluated in accordance with the modified MacNub scale at 3 months and 3 years after surgery. Results. In all cases, surgery had positive clinical effect with complete relief of the pain syndrome, including complete regression of distal paresis of the lower limb. In all patients, the 3-month result of surgery was rated on the MasNub scale as good and 3-year result - as excellent. The position of implants was stable, with no signs of further disc degeneration and decrease in interbody space. Conclusion. Closure of the annular defect after lumbar microdisectomy provides excellent long-term results in adolescents with radicular compression syndrome associated with herniated discs. However, convincing and reliable assessment of the method requires further studies with a comparative analysis using sufficient clinical material.