Intervertebral disc herniation in the adolescent.

Twenty-nine patients between 14 and 20 years of age underwent surgical treatment for intervertebral disc herniation over a 10-year period. Trauma was a significant factor in 59%. Back pain was a major complaint in all cases, and all but one had significant sciatic distress. Typical painful, restricted forward flexion was found in 22 cases. All patients had definite signs of nerve root tension. Nerve compression signs were present in 41%. Myelography was done in all cases, and discography was performed on 22 patients to aid in diagnosis and planning of definitive treatment. Twenty-three patients were followed over an average of 5.3 years. Excellent or good results were found in 89%. One patient required a further surgical procedure. Analyzing 12 procedures performed at the L5-S1 level demonstrated excellent results in all patients undergoing lumbosacral fusion combined with discotomy at this level in the presence of a normal L4-5 discogram.