Pediatrics severe low back pain by disc herniation: an uncommon entity,
Auteur(s): Wendlassida Joelle Stéphanie Tiendrebeogo/Zabsonre1* , Denlewende Sylvain Zabsonre , Fulgence Kabore , Abdoulaye Sanou, Yakouba Haro, Inoussa Zoungrana, Dieu-Donné Ouedraogo
Résumé

Background Common severe back pain due to disc herniation is rare in the paediatric population which involves
children under eighteen years of age. Paediatric lumbar disc herniation (LDH) cannot be considered the same disease
as in adults, as it has potentially different natural and clinical backgrounds. The treatment of pediatric LDH is the other
particularity of this condition. Indeed, in children, delaying surgery for a conservative treatment is justified. We report
3 cases treated in 8 years.
Case presentation Three patients, two of whom were 14 years of age and one 17 years of age, were admitted
for L5 or S1 lumbosciatica. A CT scan showed a lumbar disc herniation L5S1 associated with bi-isthmic lysis (and a
transitional abnormality in 1 case or spina bifida occulta in 1 other case). The last patient had an magnetic resonance
imaging (MRI) that showed a herniated L4L5 disc. The diagnosis of low back pain disc herniation was retained in two
patients and that of disabling low back disc in one patient. Percutaneous discolysis in the two hyperalgesic cases and
epidural corticosteroid infiltration in the disabling case were effective on lumbosciatica.
Conclusion Paediatric common lomw back pain caused by a disc herniation with a hyperalgic or disabling character
posed a therapeutic problem which were solved by the invasive approaches that must be given priority nowadays
with children.

Mots-clés

Disc herniation Pediatrics low back pain

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