Spinal Radiculopathy in Children and Adolescents Is Rare – Surgery is Even Rarer

Background and Aim
Spinal radiculopathy and radicular pain are significant causes of reduced quality of life and functional capacity, and the condition can occur as early as adolescence. Extensive research exists on radiculopathy in adults, but knowledge about epidemiology and treatment patterns in children and adolescents has so far been limited. The aim of the study was to map the annual incidence of hospital-diagnosed spinal radiculopathy and radicular pain, as well as related surgery in Denmark over a 16-year period.

Methods
Researchers analysed data from Danish national health registers for the period 2007–2022. All children and adolescents aged 6–17 years were included in the study, and diagnoses were identified using ICD-10 codes, while surgical procedures were recorded using NOMESCO procedure codes. Sociodemographic characteristics and the time span from diagnosis to surgery were also examined.

Results

• A total of 905 individuals were diagnosed with radiculopathy or nerve root pain. 61% of those diagnosed were girls, and the average age was 15.2 years.
• The annual incidence ranged from 4.5 per 100,000 (2018) to 9.3 per 100,000 (2014).
• Only 16 individuals (1.8%) underwent surgery – primarily for lumbar disc herniation or spinal stenosis.
• Median time to surgery was 4 days, and operations were typically performed quickly after diagnosis, especially in younger patients and girls.
• No children under 10 years underwent surgery.

Conclusion and Perspective
The study emphasizes that spinal radiculopathy and surgical treatment are rare among children and adolescents in Denmark. When surgery is performed, it happens soon after the diagnosis, indicating clear clinical indications. The results highlight the need for further research into disease progression, treatment strategies, and long-term outcomes – both nationally and internationally.

Relevance for Chiropractors
Although surgery is rare, radiculopathy in young people has a major impact on function and quality of life. Chiropractors play a central role in early, non-surgical treatment and in identifying patients who need referral for specialist evaluation. The study provides an important epidemiological foundation for understanding the scope of the problem and strengthening evidence-based practice.

Casper Nim, Jan Hartvigsen, Lise Hestbæk, Freja Gomez Overgaard, Andreas Kiilerich Andresen, Kieran O’Sullivan, Michael Swain, Jessica Jayne Wong, Pierre Côté. Incidence of spinal radiculopathy and surgery among 6–17 year olds: a nationwide population-based cohort study. European Spine Journal 2025.