Low back pain in children is real; and one must always take a serious look for the etiology, find the cause, and implement the real treatment. In this paper, we present two cases. One case involves a 13-year-old girl who after a failure to obtain correct diagnosis in a large prestigious medical center was under psychiatric care and lost 18 months of her schooling. A second case concerns a 17-year-old boy who was treated in a spine clinic at a noted university. During the subsequent 12 months, his condition was aggravated and progressed, leading to three herniated discs (L3-L4, L4-L5, and L5-S1) with 60° scoliosis and 30° lumbar kyphosis. It was suggested that he have anterior and posterior spinal instrumentation and fusion. Subsequently, both of these patients were diagnosed by correct history and physical examination. The diagnoses were reconfirmed by dynamic discography, and both patients were successfully treated by percutaneous discectomy as outpatients.
Example: One case here is briefly recorded. K.A. was a 13-year-old daughter of an attorney, with a history of 18 months of back pain and left sciatica. She had been treated by a family physician, chiropractor, and neurologist. She had been hospitalized for 6 weeks under the care of an orthopaedic surgeon. She was also hospitalized under the care of a neurosurgeon for another 8 weeks. She was unable to sit and could not go to school. She was under the care of a psychiatrist and was treated under a diagnosis of "teenage crush syndrome."
Conclusion: Low back pain in children is real and deserves a full investigation by a specialist. Percutaneous discography and discectomy is recommended as a safe treatment of choice when conservative treatment fails.
