Kumar Ashwin, Ramachandraiah Manoj K, Nagendra Kavitha R, Venkataraman Sagar, S Nagakumar J
Orthopaedics, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND.
Physiotherapy, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND.
Cureus. 2025 Apr 25;17(4):e82979. doi: 10.7759/cureus.82979. eCollection 2025 Apr.
Background Lumbar disc herniation (LDH) is rare in adolescents, with an incidence of 1-5% in individuals under 20 years of age. The condition often manifests as radiculopathy, with or without back pain, posing diagnostic challenges due to differential diagnoses like musculoskeletal disorders. While conservative management is the first-line approach for most patients, surgical intervention is recommended for severe cases or when conservative measures fail. Objectives This study aimed to compare functional outcomes in adolescent patients with symptomatic LDH treated conservatively versus surgically. Methods A retrospective study was conducted at R.L. Jalappa Hospital, Kolar, India, between May 2023 and April 2024. The study included 44 patients aged 10-19 years with MRI-confirmed LDH. Participants were divided into two groups: conservative management (n = 22) and surgical management (n = 22). Visual analog scale (VAS) and Oswestry Disability Scale (ODS) were used to assess outcomes. Statistical analysis was performed using independent t-tests and chi-square tests, with a significance threshold of p < 0.05. Results The mean age was 15.95 ± 0.844 in the conservative group and 16.00 ± 0.816 in the surgical group, with equal gender distribution. VAS scores before and after management showed no significant difference between the groups (p = 0.898 and p = 1.000, respectively). ODS scores after management were significantly better in the surgical group (p = 0.024). Complications were minimal and comparable (p = 0.709). Conclusion Both conservative and surgical management effectively reduced pain in adolescent LDH patients, but surgical management demonstrated superior functional outcomes. Complication rates were low and comparable. Further studies with larger sample sizes and longer follow-up are recommended.
腰椎间盘突出症（LDH）在青少年中较为罕见，20岁以下人群的发病率为1%-5%。该病常表现为神经根病，伴有或不伴有背痛，由于与肌肉骨骼疾病等鉴别诊断存在差异，给诊断带来挑战。虽然保守治疗是大多数患者的一线治疗方法，但对于严重病例或保守治疗失败的情况，建议进行手术干预。目的：本研究旨在比较保守治疗与手术治疗的青少年症状性LDH患者的功能结局。方法：于2023年5月至2024年4月在印度科拉尔的R.L.贾拉帕医院进行了一项回顾性研究。该研究纳入了44例年龄在10-19岁、MRI确诊为LDH的患者。参与者被分为两组：保守治疗组（n = 22）和手术治疗组（n = 22）。采用视觉模拟量表（VAS）和奥斯威斯利功能障碍指数（ODS）评估结局。使用独立t检验和卡方检验进行统计分析，显著性阈值为p < 0.05。结果：保守治疗组的平均年龄为15.95±0.844岁，手术治疗组为16.00±0.816岁，两组性别分布均衡。治疗前后的VAS评分在两组之间无显著差异（分别为p = 0.898和p = 1.000）。治疗后的ODS评分在手术治疗组明显更好（p = 0.024）。并发症极少且相当（p = 0.709）。结论：保守治疗和手术治疗均能有效减轻青少年LDH患者的疼痛，但手术治疗显示出更好的功能结局。并发症发生率较低且相当。建议进行更大样本量和更长随访时间的进一步研究。
