{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:18:08Z","timestamp":1787811488970,"version":"build-2784847793"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric and adolescent lumbar disc herniation (LDH) is uncommon, and recovery after microdiscectomy may differ across pain, disability, and outcome domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective single-center case series included patients younger than 18 years of age who underwent microdiscectomy for LDH between 2022 and 2025 and had complete 12-month outcome data. Low back and radicular leg pain were assessed using the visual analog scale (VAS), disability using the Oswestry Disability Index (ODI), and global outcome using the modified MacNab criteria. Longitudinal changes were analyzed using Friedman tests and Holm-adjusted pairwise comparisons. A\n                      <jats:italic>post hoc<\/jats:italic>\n                      responder analysis applied adult-derived absolute thresholds and a reduction of at least 30%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen patients were included (median age, 16 years; median follow-up, 21 months). The median low back pain VAS score increased from 4 preoperatively to 7 early postoperatively and then decreased to 1 at 3 and 12 months (overall\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The median radicular leg pain VAS score decreased from 8 preoperatively to 2 early postoperatively and 1 at 3 and 12 months (overall\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The median ODI score decreased from 50 preoperatively to 12 at 3 months and 6 at 12 months (overall\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), with further improvement between 3 and 12 months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). All evaluable patients met both responder criteria from baseline to 3 and 12 months. Modified MacNab categories did not change significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.313). No complications occurred; two patients developed recurrence and one underwent reoperation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pain, disability, and global outcome followed distinct trajectories. These exploratory findings support separate assessment of recovery domains and require confirmation in larger multicenter cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1913776","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:33:56Z","timestamp":1787808836000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and distinct recovery trajectories of pain and disability after lumbar microdiscectomy in children and adolescents"],"prefix":"10.3389","volume":"13","author":[{"given":"Muhammed Erkan","family":"Emraho\u011flu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Kavcar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdal Re\u015fit","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcseyin","family":"Bozkurt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Kalan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"G\u00fcnayd\u0131n","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Yakupo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halil","family":"G\u00f6k","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levent","family":"G\u00fcrses","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ankara Etlik City Hospital","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emrah","family":"Keskin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Zonguldak B\u00fclent Ecevit University","place":["Zonguldak, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selim","family":"Gel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Trabzon University","place":["Trabzon, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Erhan","family":"T\u00fcrko\u011flu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hacettepe University","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s00586-009-1202-7","article-title":"A review of current treatment for lumbar disc herniation in children and adolescents","volume":"19","author":"Dang","year":"2010","journal-title":"Eur Spine J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1007\/s00381-007-0370-1","article-title":"Adolescent lumbar disc disease: findings and outcome","volume":"23","author":"Kumar","year":"2007","journal-title":"Childs Nerv Syst"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e911","DOI":"10.1016\/j.wneu.2021.05.007","article-title":"Comparison of percutaneous endoscopic lumbar discectomy and open lumbar discectomy in the treatment of adolescent lumbar disc herniation: a retrospective analysis","volume":"151","author":"Yu","year":"2021","journal-title":"World Neurosurg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1159\/000120676","article-title":"Lumbar intervertebral disc disease in the pediatric population","volume":"18","author":"Gennuso","year":"1992","journal-title":"Pediatr Neurosurg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s12178-017-9441-4","article-title":"Lumbar disc herniation","volume":"10","author":"Amin","year":"2017","journal-title":"Curr Rev Musculoskelet Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1007\/s00381-003-0720-6","article-title":"Lumbar disc herniation in early childhood: case report and literature review","volume":"19","author":"Mart\u00ednez-Lage","year":"2003","journal-title":"Childs Nerv Syst"},{"key":"B7","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1159\/000355127","article-title":"Ring apophysis fracture in pediatric lumbar disc herniation: a common entity","volume":"49","author":"Singhal","year":"2013","journal-title":"Pediatr Neurosurg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"105486","DOI":"10.1016\/j.clineuro.2019.105486","article-title":"Surgical management of lumbar disc herniation in children and adolescents","volume":"185","author":"Raghu","year":"2019","journal-title":"Clin Neurol Neurosurg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"165","DOI":"10.3171\/2009.9.SPINE09756","article-title":"Lumbar microdiscectomy in pediatric patients: a large single-institution series","volume":"12","author":"Cahill","year":"2010","journal-title":"J Neurosurg Spine"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e63880","DOI":"10.7759\/cureus.63880","article-title":"Discectomy for lumbar disc herniation in pediatric and adolescent populations: a systematic review and meta-analysis","volume":"16","author":"Than","year":"2024","journal-title":"Cureus"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e314","DOI":"10.1016\/j.wneu.2020.12.126","article-title":"Adolescent disc disease: risk factors and treatment success-related factors","volume":"148","author":"Shimony","year":"2021","journal-title":"World Neurosurg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1016\/j.spinee.2007.11.006","article-title":"Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study Questionnaire Short Form 36, and pain scales","volume":"8","author":"Copay","year":"2008","journal-title":"Spine J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/j.spinee.2020.01.010","article-title":"Measuring clinically relevant improvement after lumbar spine surgery: is it time for something new?","volume":"20","author":"Asher","year":"2020","journal-title":"Spine J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"643","DOI":"10.3171\/jns.1987.67.5.0643","article-title":"Results of lumbar discectomy in the pediatric patient","volume":"67","author":"Ebersold","year":"1987","journal-title":"J Neurosurg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/0090-3019(96)00035-3","article-title":"Pediatric lumbar disc surgery: 20 patients under 15 years of age","volume":"46","author":"Shillito","year":"1996","journal-title":"Surg Neurol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/s40001-022-00696-x","article-title":"Pediatric lumbar disc herniation: a report of two cases and review of the literature","volume":"27","author":"Wang","year":"2022","journal-title":"Eur J Med Res"},{"key":"B17","doi-asserted-by":"publisher","first-page":"449","DOI":"10.3171\/2017.11.PEDS17293","article-title":"Tubular approach to minimally invasive microdiscectomy for pediatric lumbar disc herniation","volume":"21","author":"Montejo","year":"2018","journal-title":"J Neurosurg Pediatr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s00381-003-0890-2","article-title":"Cauda equina compression syndrome in a child due to lumbar disc herniation","volume":"20","author":"Kotil","year":"2004","journal-title":"Childs Nerv Syst"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3171\/spi.2000.92.1.0001","article-title":"Surgically treated lumbar disc disease in the pediatric population: an outcome study","volume":"92","author":"Durham","year":"2000","journal-title":"J Neurosurg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1007\/s00701-026-06956-7","article-title":"Juvenile lumbar disc herniation: impact of delayed diagnosis and surgical treatment on outcome in a 10-year single-center series","volume":"168","author":"H\u00f8stm\u00e6lingen","year":"2026","journal-title":"Acta Neurochir (Wien)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1186\/s12891-023-06842-8","article-title":"Surgical outcomes of percutaneous endoscopic lumbar discectomy in obese adolescents with lumbar disc herniation","volume":"24","author":"Qu","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"B22","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1007\/s00381-013-2320-4","article-title":"Percutaneous endoscopic interlaminar discectomy for pediatric lumbar disc herniation","volume":"30","author":"Wang","year":"2014","journal-title":"Childs Nerv Syst"},{"key":"B23","doi-asserted-by":"publisher","first-page":"300060520986685","DOI":"10.1177\/0300060520986685","article-title":"Efficacy of percutaneous endoscopic lumbar discectomy for pediatric lumbar disc herniation and degeneration on magnetic resonance imaging: case series and literature review","volume":"49","author":"Lin","year":"2021","journal-title":"J Int Med Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e255","DOI":"10.1016\/j.wneu.2018.01.030","article-title":"Comparison of MED and PELD in the treatment of adolescent lumbar disc herniation: a 5-year retrospective follow-up","volume":"112","author":"Li","year":"2018","journal-title":"World Neurosurg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"330","DOI":"10.4274\/BMJ.galenos.2022.2022.6-16","article-title":"Pediatric lumbar microdiscectomy","volume":"18","author":"G\u00fc\u00e7l\u00fc","year":"2022","journal-title":"Med J Bakirkoy"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1913776\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:33:57Z","timestamp":1787808837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1913776\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":25,"alternative-id":["10.3389\/fsurg.2026.1913776"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1913776","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"article-number":"1913776"}}