Abstract
Background:
Compared with adults, children with intervertebral disc herniation often face delayed diagnoses due to atypical presentations and symptom overlap with other musculoskeletal disorders. While non-operative treatments such as physical therapy and NSAIDs are typically first-line, they may be insufficient in severe cases, where discectomy can be effective but carries a risk of recurrence. PROMIS (Patient-Reported Outcomes Measurement Information System) offers standardized measures of patient-reported pain and function. This study aims to evaluate PROMIS Pain Interference (Pain) and Mobility scores in pediatric disc herniation patients compared with the population average and assess treatment outcomes between non-operative and surgical cohorts.
Methods:
A retrospective cohort analysis included patients t
tests and linear mixed-effects models (α=0.05).
Results:
Eighty patients (median age 16) met the inclusion criteria; 42 received non-operative care, and 38 underwent surgery. At presentation, mean PROMIS Pain was 59±7, and Mobility was 35±6, both significantly different from the norm (
P
P
P
Conclusion:
Pediatric patients with disc herniations experience significant pain and limited mobility. Patients who elect for discectomy present with worse pain and decreased mobility at baseline. However, those who undergo surgery can expect quicker relief of symptoms, and despite initially worse function, ultimately achieve outcome scores comparable to patients successfully managed non-operatively. Our study further validates that PROMIS scores effectively quantify symptom burden in pediatric disc herniation and reflect treatment response, supporting their use in this population.
Level of Evidence:
Level III—retrospective comparative study.