2013 Volume 25 Issue 1 Pages 201-206
Objective: The purpose of this study was to investigate and clarify the characteristics of lumbar disc herniation (LDH) in younger patients.
Patients and Methods: The case group comprised 50 patients under 20 years of age who underwent microscopic discectomy, microendoscopic discectomy, and bilateral fenestration and discectomy. The control group comprised 50 patients age between 30 and 60 years who were treated by microscopic discectomy. The average ages of the case group and the control group were 17.9 years and 44.5 years, respectively, and the average follow-up periods were 6.3 months and 7.7 months, respectively.
Results: Compared with the control group, most of the patients in the case group had subligamentous-type herniation (84%); transligamentous and sequestrated herniation was relatively rare. The preoperative Japanese Orthopedic Association score (JOA score) for the case group was significantly less than that for the control group in terms of lumbago and straight-leg raising (SLR). The average JOA score increased by 6.4 points postoperatively in the case group and 5.3 points in the control group.
Conclusions: Clinically, younger LDH patients tend to have lumbago and severely positive SLR in comparison with adult patients. As most of the herniations in younger patients are the subligamentous type, if conservative therapy is unsuccessful, operative treatment should be considered.
