{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:07:18Z","timestamp":1790892438204,"version":"4.1.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Lumbar disc herniation (LDH) in the pediatric population is rare and exhibits unique characteristics compared with adult LDH. There are limited data regarding the safety and efficacy of minimally invasive surgery (MIS) using tubular retractors in pediatric patients with LDH. Here, the outcomes of MIS tubular microdiscectomy for the treatment of pediatric LDH are evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Twelve consecutive pediatric patients with LDH were treated with MIS tubular microdiscectomy at the authors\u2019 institution between July 2011 and October 2015. Data were gathered from retrospective chart review and from mail or electronic questionnaires. The Macnab criteria and the Oswestry Disability Index (ODI) were used for outcome measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The mean age at surgery was 17 \u00b1 1.6 years (range 13\u201319 years). Seven patients were female (58%). Prior to surgical intervention, 100% of patients underwent conservative treatment, and 50% had epidural steroid injections. Preoperative low-back and leg pain, positive straight leg raise, and myotomal leg weakness were noted in 100%, 83%, and 67% of patients, respectively. The median duration of symptoms prior to surgery was 9 months (range 1\u201336 months). The LDH level was L5\u2013S1 in 75% of patients and L4\u20135 in 25%. The mean \u00b1 SD operative time was 90 \u00b1 21 minutes, the estimated blood loss was \u2264 25 ml in 92% of patients (maximum 50 ml), and no intraoperative or postoperative complications were noted at 30 days. The median hospital length of stay was 1 day (range 0\u20133 days). The median follow-up duration was 2.2 years (range 0\u20135.8 years). One patient experienced reherniation at 18 months after the initial operation and required a second same-level MIS tubular microdiscectomy to achieve resolution of symptoms. Of the 11 patients seen for follow-up, 10 patients (91%) reported excellent or good satisfaction according to the Macnab criteria at the last follow-up. Only 1 patient reported a fair level of satisfaction by using the same criteria. Seven patients completed an ODI evaluation at the last follow-up. For these 7 patients, the mean ODI low-back pain score was 19.7% (SEM 2.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>To the authors\u2019 knowledge, this is the longest outcomes study and the largest series of pediatric patients with LDH who were treated with MIS microdiscectomy using tubular retractors. These data suggest that MIS tubular microdiscectomy is safe and efficacious for pediatric LDH. Larger prospective cohort studies with longer follow-up are needed to better evaluate the long-term efficacy of MIS tubular microdiscectomy versus other open and MIS techniques for the treatment of pediatric LDH.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.11.peds17293","type":"journal-article","created":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T14:55:23Z","timestamp":1519397723000},"page":"449-455","source":"Crossref","is-referenced-by-count":21,"title":["Tubular approach to minimally invasive microdiscectomy for pediatric lumbar disc herniation"],"prefix":"10.3171","volume":"21","author":[{"given":"Julio D.","family":"Montejo","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquin Q.","family":"Camara-Quintana","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Duran","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannine M.","family":"Rockefeller","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sierra B.","family":"Conine","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa M.","family":"Blaise","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristopher T.","family":"Kahle","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"DiLuna","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1016\/j.wneu.2016.05.073","article-title":"The clinical significance of lumbosacral transitional vertebrae on the surgical outcomes of lumbar discectomy: a retrospective cohort study of young adults","volume":"99","author":"Ahn SS","year":"2017","unstructured":"Ahn SS, Chin DK, Kim SH, Kim DW, Lee BH, Ku MG: The clinical significance of lumbosacral transitional vertebrae on the surgical outcomes of lumbar discectomy: a retrospective cohort study of young adults. 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