STUDY DESIGN: This study retrospectively analyzed 15 patients in the rarely seen young (under 21 years) age group who had undergone discectomy without fusion for prolapsed (herniated) lumbar disc. OBJECTIVES: The results were analyzed for degree of success in several outcome parameters to relate the efficacy of this patient group/procedure pair to that of other studies. SUMMARY OF BACKGROUND DATA: Sixteen operations were performed on this patient group, including six by a conventional procedure and ten by a microsurgical technique. Although most previous studies tend to support the use of discectomy, some physicians have reportedly been reluctant to implement these procedures in young patients. METHODS: Patients were followed in a short-term (median 3.3 months) assessment using records of post-operative office visits. Long-term (median, 10.5 years) follow-up was done by a mailed, self-report questionnaire that quantified pain in leg and back and scored for degree of success in ability to return to normal activities and satisfaction with the results of surgery. RESULTS: The short-term results were excellent for all but one patient. Long-term follow-up yielded the following successful outcomes: relief of back pain, 77%; and relief of leg pain, return to normal activities, and satisfaction with surgery, each 85%. CONCLUSION: Despite some tendency to delay discectomy in children and young adults, physicians are urged to be aware of this rare condition and the excellent long-term outcomes and limited complications resulting from timely implementation of discectomy after a failed course of conservative therapy. Moreover, fusion should be avoided except in cases of vertebral instability.
STUDY DESIGN: This study retrospectively analyzed 15 patients in the rarely seen young (under 21 years) age group who had undergone discectomy without fusion for prolapsed (herniated) lumbar disc. OBJECTIVES: The results were analyzed for degree of success in several outcome parameters to relate the efficacy of this patient group/procedure pair to that of other studies. SUMMARY OF BACKGROUND DATA: Sixteen operations were performed on this patient group, including six by a conventional procedure and ten by a microsurgical technique. Although most previous studies tend to support the use of discectomy, some physicians have reportedly been reluctant to implement these procedures in young patients. METHODS:Patients were followed in a short-term (median 3.3 months) assessment using records of post-operative office visits. Long-term (median, 10.5 years) follow-up was done by a mailed, self-report questionnaire that quantified pain in leg and back and scored for degree of success in ability to return to normal activities and satisfaction with the results of surgery. RESULTS: The short-term results were excellent for all but one patient. Long-term follow-up yielded the following successful outcomes: relief of back pain, 77%; and relief of leg pain, return to normal activities, and satisfaction with surgery, each 85%. CONCLUSION: Despite some tendency to delay discectomy in children and young adults, physicians are urged to be aware of this rare condition and the excellent long-term outcomes and limited complications resulting from timely implementation of discectomy after a failed course of conservative therapy. Moreover, fusion should be avoided except in cases of vertebral instability.