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  • chall
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    Hi Doctor, My 17 year old son recently suffered a lower back injury playing soccer. We didn’t think much of it but it gradually got worse. Tried almost everything and nothing has helped. We finally had an MRI and then a CT scan due to some possible bone fragments ripped from the spine when the disc herniated. One doctor has read the scan one way and the doctor who did his injection had another different opinion. My son is supposed to play college soccer on scholarship next year and is very worried about his future because of this as are we. The second doctor said that the swelling need to reduce to pull the bone back into the proper place on the spine to then reattach. The other doctor didn’t say that and thought he would be back up and rolling in a month or two. We are so worried for him and want to do the right thing just not sure what that is at this point. Thanks so much for your time.
    Curtis Hall

    Donald Corenman, MD, DC
    Moderator
    Post count: 8459

    What typically happens to athletic young individuals (males much greater incidence than females) is an avulsion of the growth plate with a disc herniation. Normally, in an adult, the fibers of the annulus fibrosis tear as the weakest portion of the disc are the annulus fibers themselves.

    In kids and young adults with open growth plates (up to the ages of 17-20) the weakest point is not the annulus but the growth plate (where the annulus inserts). This bony ridge “breaks off” and the disc herniation (the nucleus that bulges out) pushes this bony fragment into the canal.

    This fragment will typically reunite with the bone of the vertebral body but will not “be pulled back into place”. Most likely, there will be a residual bony spur left behind. This spur may or may not cause nerve compression or irritation. Interestingly, most kids do not develop leg pain from this type of hernation but will have lower back pain and sacroiliac or buttocks pain only.

    A good physical therapy program is helpful and on occasion if the symptoms warrant it, an epidural steroid injection will also be helpful.

    Dr. Corenman

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