Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options

Abstract Adolescent lumbar disc herniation (ALDH) is a type of disease with a much lower incidence than adult lumbar disc herniation (LDH), which has a trend of increasing year by year. If the diagnosis is not timely or the treatment is not appropriate, it will have a serious impact on the adolescen...

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Main Authors: Jing Zhang, Wanhao Zhang, Wenjie Yue, Wenhe Qin, Zhonghai Li, Gang Xu
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-06024-3
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author Jing Zhang
Wanhao Zhang
Wenjie Yue
Wenhe Qin
Zhonghai Li
Gang Xu
author_facet Jing Zhang
Wanhao Zhang
Wenjie Yue
Wenhe Qin
Zhonghai Li
Gang Xu
author_sort Jing Zhang
collection DOAJ
description Abstract Adolescent lumbar disc herniation (ALDH) is a type of disease with a much lower incidence than adult lumbar disc herniation (LDH), which has a trend of increasing year by year. If the diagnosis is not timely or the treatment is not appropriate, it will have a serious impact on the adolescent’s psychology. The etiology of ALDH remains unclear, and it is thought that trauma, genetic, immunity, developmental abnormalities, and biomechanical abnormalities contribute to the onset and accelerate ALDH’s progression. The diagnosis of ALDH is similar to that of adults, but it has its characteristics, such as a positive straight leg raising (SLR) test in nearly 90% of patients, and posterior apophyseal ring fracture (PARF) is considered a characteristic imaging finding of ALDH. First-line treatment for ALDH remains conservative, although it is less effective than in adults. With the development of regenerative medicine, more and more treatment methods for small traumas have been applied to ALDH and achieved satisfactory treatment results. In the case of the above treatment, the effect is not satisfactory, surgery has become the last choice, different from the earliest use of open discectomy combined with fusion surgery, now more and more surgeries tend to use spinal endoscopic operation to solve, especially patients combined with some high-risk factors, and achieved satisfactory results. With the deepening of ALDH research, the etiology and mechanism of ALDH may be more fully understood. At the same time, with the development of Artificial intelligence (AI) technology, it is believed that in the near future, AI can provide references in the timing of conservative treatment for ALDH, the selection of surgical modalities, and the prediction of postoperative complications.
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spelling doaj-art-613629a3e4364105beacd6ff0b8a0f302025-08-20T03:47:16ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-06-0120111710.1186/s13018-025-06024-3Adolescent lumbar disc herniation: etiology, diagnosis, and treatment optionsJing Zhang0Wanhao Zhang1Wenjie Yue2Wenhe Qin3Zhonghai Li4Gang Xu5Department of Orthopaedics, First Affiliated Hospital of Dalian Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Dalian Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Dalian Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Dalian Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Dalian Medical UniversityDepartment of Orthopaedics, First Affiliated Hospital of Dalian Medical UniversityAbstract Adolescent lumbar disc herniation (ALDH) is a type of disease with a much lower incidence than adult lumbar disc herniation (LDH), which has a trend of increasing year by year. If the diagnosis is not timely or the treatment is not appropriate, it will have a serious impact on the adolescent’s psychology. The etiology of ALDH remains unclear, and it is thought that trauma, genetic, immunity, developmental abnormalities, and biomechanical abnormalities contribute to the onset and accelerate ALDH’s progression. The diagnosis of ALDH is similar to that of adults, but it has its characteristics, such as a positive straight leg raising (SLR) test in nearly 90% of patients, and posterior apophyseal ring fracture (PARF) is considered a characteristic imaging finding of ALDH. First-line treatment for ALDH remains conservative, although it is less effective than in adults. With the development of regenerative medicine, more and more treatment methods for small traumas have been applied to ALDH and achieved satisfactory treatment results. In the case of the above treatment, the effect is not satisfactory, surgery has become the last choice, different from the earliest use of open discectomy combined with fusion surgery, now more and more surgeries tend to use spinal endoscopic operation to solve, especially patients combined with some high-risk factors, and achieved satisfactory results. With the deepening of ALDH research, the etiology and mechanism of ALDH may be more fully understood. At the same time, with the development of Artificial intelligence (AI) technology, it is believed that in the near future, AI can provide references in the timing of conservative treatment for ALDH, the selection of surgical modalities, and the prediction of postoperative complications.https://doi.org/10.1186/s13018-025-06024-3Adolescent lumbar disc herniationEpidemiologyEtiologyPathogenesisDiagnosisTreatment
spellingShingle Jing Zhang
Wanhao Zhang
Wenjie Yue
Wenhe Qin
Zhonghai Li
Gang Xu
Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options
Journal of Orthopaedic Surgery and Research
Adolescent lumbar disc herniation
Epidemiology
Etiology
Pathogenesis
Diagnosis
Treatment
title Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options
title_full Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options
title_fullStr Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options
title_full_unstemmed Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options
title_short Adolescent lumbar disc herniation: etiology, diagnosis, and treatment options
title_sort adolescent lumbar disc herniation etiology diagnosis and treatment options
topic Adolescent lumbar disc herniation
Epidemiology
Etiology
Pathogenesis
Diagnosis
Treatment
url https://doi.org/10.1186/s13018-025-06024-3
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AT wenheqin adolescentlumbardischerniationetiologydiagnosisandtreatmentoptions
AT zhonghaili adolescentlumbardischerniationetiologydiagnosisandtreatmentoptions
AT gangxu adolescentlumbardischerniationetiologydiagnosisandtreatmentoptions