A herniated disc of the lumbar spine can cause scoliosis in adolescents

Oct 3 2011
For the first time, researchers have studied the pattern of scoliosis in adolescents who endured a herniated disc of the lumbar spine. Their study suggests that these patients would benefit from corrective spine surgery soon after diagnosis.

The spinal column is made up of the vertebrae, the facet joints and the intervertebral discs that act as shock absorbers in between the bones. A herniated disc occurs when one of these shock absorbers ruptures or bulges out, which can put pressure on the surrounding nerves and cause pain to radiate to other parts of the body. These herniations may occur because of injury or mechanical wear and tear to the disc over time. The condition can be corrected with a spine surgery known as a discectomy, which removes part or all of the offending structure to relieve the pressure on the nerves.

Herniated discs in the lumbar spine are pretty rare in adolescents, but may happen because of injury or hereditary conditions, as noted in a study published Sept. 30 in BMC Musculoskeletal Disorders. The symptoms of a herniation may be different for younger patients as they are in adults. Adolescents may experience lower back pain, leg pain, difficulty walking and muscle spasms. However, both adolescents and adults may also develop an abnormal curvature of the spine known as scoliosis.

Up to 3 percent of Americans have scoliosis, totaling about 6 million people in the U.S. Besides back pain, the condition may also cause difficulty breathing and poor self-esteem. About 85 percent of cases are considered idiopathic, meaning doctors cannot determine the cause, but in the case of lumbar disc herniation, scoliosis may develop as the body's way of taking pressure off of the nerves.

Researchers in China wanted to evaluate the effects of lumbar disc herniations in adolescents with scoliosis. They reviewed the medical records of 26 patients between the ages of 14 and 20 years, who initially came to the clinic for what looked like scoliosis. Several eventually had a discectomy. Radiological images helped the researchers see the pattern of how scoliosis progresses in adolescents who have had a lumbar disc herniation. Furthermore, the review revealed that some patients were misdiagnosed with idiopathic scoliosis, likely because lumbar disc herniations are so rare in this age group and symptoms may not resemble those of adults.

For adolescents, a discectomy or similar procedure should be considered early on not just because scoliosis can be psychologically damaging at this age, but also because their younger bodies could be more responsive to corrective surgery.

The researchers caution that their study only included patients for whom conservative treatment didn't work.