Etiology of lumbar disc herniation in adolescents: excessive load on the lumbar spine and aberrant configurations of the lumbosacral region

English Keywords:Lumbar disc herniation  Children  Adolescents  Iliolumbar ligament  Intercrestal line

English Abstract:

  【Abstract】 Objectives: To analyze the causes of the lumbar intervertebral disc herniation in adolescents, and to investigate the significance of the morphological variation of bone and joint structure in the pathogenesis of disease. Methods: A total of 76 consecutive adolescents suffering from lumbar disc herniation and treated in a single medical institute during January 2006 to December 2014 were retrospectively studied. Patients′ onset of symptoms, body heights, weights and BMI were compared with those of the group with the same average age in the previous reports. Cases with single level disc herniation involving L4/5 or L5/S1 level were totally 63 and measured for lumbar spine configurations. Lumbar spine configurations included the height of intercrestal line, the length of L5 transverse processes and the presence of transitional vertebrae in anteroposterior radiographs, which were compared and analyzed for relationship with the level of disc herniation. Results: Both males and females in the study under 19 years old(61 cases) had significantly higher body height and greater weight in comparison with the group with the same average age in the previous reports. Patients with high or normal intercrestal lines(33 cases), long L5 transverse processes(44 cases) and with lumbar sacralization(44 cases) had significantly higher incidence of L4/5 disc herniation, 97.0%(32/33), 70.5%(31/44) and 68.2%(30/44) respectively; while low intercrestal lines(30 cases), normal L5 transverse processes(19 cases) and lumbarization(19 cases) were associated with L5/S1 disc herniation, 86.7%(26/30), 73.7%(14/19), and 68.4%(13/19) respectively. Conclusions: Lumbar disc herniation in children and adolescents is significantly associated with patients′ height, body weight, BMI and configurations of the lumbar spine.