Adolescent lumbar disc disease: findings and outcome

Lumbar disc herniation is mainly a disease of elderly people as degenerative changes progress with age. Present retrospective analysis was performed on 742 patients of lumbar disc disease operated over 11 years. Of 742 cases aged 20 years or less, 25 has been evaluated to see the clinical features, radiological features, operative findings, and outcome of lumbar disc surgery. The incidence of lumbar disc herniation in pediatric and adolescent populations was 3.5% (aged 20 years or less). All patients presented with low back pain with or without radiculopathy (n = 25). Diagnosis was easily made on magnetic resonance imaging. Gross degenerative changes in disc and end plates were uncommon (16%) in this population. The trauma may not be a predisposing factor in most of them. In 88% (n = 22) of the cases, only 1 level was affected; the commonest was L4-5 (n = 13). Disc herniation was centrolateral in 72% (n = 18) and central in 28% (n = 7). Disc was mostly soft, hydrated, and rubbery in 92% (n = 23). Disc herniation were subligamentous in 80% (n = 20) and extruded in 4% (n = 1). Sixteen percent (n = 4) of the patients had disc bulge with intact annulus. Operative intervention in the form of simple discectomy offers good result in 92% (n = 23) cases irrespective of approach and method. Longer follow-up is mandatory because the chances of recurrence or another level involvement cannot be denied.