BACKGROUND: Intervertebral disc herniation (IVDH) is rare in adolescent populations, and most respond well to conservative management or a single surgical intervention. Recurrent postoperative herniations are uncommon and pose unique management challenges.

CASE REPORT: We present a 19-year-old woman with no major risk factors who experienced 4 lumbar IVDHs, requiring 3 microdiscectomies and one revision surgery between ages 16 and 19. Despite following medical and rehabilitation protocols and receiving multiple epidural steroid injections, she developed recurrent radicular symptoms and progressive neurological deficits, ultimately requiring an L3-L4 microdiscectomy. Postoperatively, she showed improvement in pain and overall functional status.

CONCLUSIONS: This case highlights the limitations of adult-based treatment paradigms for adolescent IVDH. Recurrent herniations in these patients underscore the need for dedicated treatment protocols, long-term follow-up strategies, and further research into age-specific medical, interventional, and surgical management approaches.

KEYWORDS: Intervertebral disc herniation, discectomy, epidural steroid injection, microdiscectomy