lumbar hernia in children,

Herniated disc in children is a much less common disorder than adults. Considering all cases of herniated disc in children, this disease constitutes a rate of approximately 1%. It can be found together with some structural abnormalities, such as congenital anomalies, stenosis of the spinal canal, and lumbar shift, which are frequently related to the lumbar bones.

At the onset of the disease, there is usually a history of trauma, such as a sports injury, a fall, heavy lifting, or a reverse movement. But in some cases, such a story cannot be obtained despite all the interrogation. Our experience has also shown that lumbar hernia in children is most common in the adolescence period. This situation can be explained by the excessive mobility and rapid growth of the spine during adolescence. If a child in this period is brought to the doctor with a complaint of low back pain, structural disorders, some congenital diseases, various slips in the waist and infection of the disc should always be considered in the diagnosis, besides herniated disc.

Although low back pain is the most common complaint, leg pain is also frequently encountered in the clinic. Sometimes both can be seen together. There may be gait disturbance, bending of the spine, spasm in the lumbar muscles and limitation of movement. Neurological findings such as loss of sensation, strength and reflexes, and complaints such as urinary and stool incontinence or inability to do so are rare in children. The most important clinical finding is pain when raising the leg straight into the air.

Plain x-ray films are instructive. Computed tomography and especially magnetic resonance imaging method are very valuable in diagnosis. Sometimes it may be necessary to refer to bone scintigraphy. After the diagnosis is made clearly, treatment is started. Non-surgical methods such as the application of painkillers called conservative treatment, firm bed rest, physical therapy and low back pull do not give as good results in children as in adults, and they benefit only a few of the patients. Even if improvement is observed, the patient’s complaints may recur after a while. On the other hand, surgical treatment in children is very satisfactory as a result of adequate and appropriate surgery. Patients can fully regain their former activities and participate in sports. Almost all of the doctors who are the authority in the world who deal with lumbar hernia share this view.

The vertebral bones in children contain a cartilage plate on both upper and lower surfaces since birth. The epiphysis is located in the part where these cartilage plates come in contact with the bone body, and the vertebral bones ossify from these regions on both plates. As children mature, vertebrae grow from these parts. The cartilage plates here adhere to the bone at about 17 years of age, ossify around the age of 20 and fuse with the body of the vertebral bones. From this moment on, the growth of the vertebrae ends.

Epiphyses function actively during the growth period and under normal conditions they perform a symmetrical growth. This growth is significantly affected by the pressure applied to the epiphyseal layers. While the application of symmetrical pressure distributed evenly on the epiphyseal layers results in symmetrical growth, the asymmetrically applied pressure creates asymmetrical growth and therefore deformity and a crooked structure in the vertebrae. In fact, this asymmetry is reflected in the internal structure of the bone and there is no healthy bone development.

For this reason, children in the age of development carrying heavy loads and carrying the load from one place to another, especially with their bodies, in an asymmetrical manner will put the load on the epiphyses in the vertebrae unevenly, and therefore, healthy bone development will not occur. That’s why we say that our children should not carry heavy school bags as much as possible. Let them take only the books and materials that are relevant to the lessons of that day, and leave the others. They should not keep any unnecessary weights in their bags. In fact, if the school’s facilities are available, it will be very convenient to allocate a locker for the children at the school. In addition, the weights should be distributed equally in both hands or distributed symmetrically and evenly on the back. In this way, they will both feel comfortable and have already taken precautions for some discomforts that may occur in the spine in the following years.