Minimally invasive surgical treatment of adolescent lumbar disc herniation / 局解手术学杂志

ABSTRACT

Objective To discuss the clinical characteristics and treatment methods of lumbar disc herniation in adolescent and to in-crease the awareness of lumbar disc herniation among orthopedists.Methods Retrospectively reviewed the clinical data of 201 adolescent pa-tients(aged 20 years or less)with lumbar disc herniation who were admitted in General Hospital of Shenyang Military Area Command from January 2001 to December 2010.Analyzed the clinical characteristics and treatment methods,and compared the VAS score and ODI score be-fore operation,one week after operation and at the last follow up.Meanwhile,the complications were observed and compared.Results Among the 201 patients,187 patients(93.0%)presented with low back pain with or without radiating pain,20 patients(10.0%)presented with leg pain for the first symptom.There were only 97 patients(48.3%)were diagnosed with lumbar disc herniation for their first diagnosis in other hospital.Totally 70 patients(34.8%)had a history of trauma before the onset.The most common segments were L4 /L5 (101 cases,50.2%) and L5 /S1 (70 cases,34.8%).There were 140 patients treated by microendoscopy discectomy(MED),25 patients treated by percutaneous endoscopic lumbar discectomy(PELD),and 36 patients treated by open lumbar discectomy(OLD).All the patients were followed up for more than 12 months with averagely followed up for(22.9 ±11.7)months.There was significant improvement one week after operation and at the last follow up compared with the preoperative VAS score and ODI score,and the differences were statistically significant(P <0.05).The rate of postoperative complications was 3.6%,4.0%,8.3% in patients with MED,PELD and OLD respectively.Conclusion Diagnosis of LDH in adolescent is usually delayed.Increase the awareness of lumbar disc herniation could help orthopedists to get a exact medical history,per-form a directed physical examination,and order appropriate imaging studies.Minimally invasive surgery is an effective method to treat lumbar disc herniation in adolescent.