Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2002 Dec;9(4):322-331. Korean.
    Published online Dec 31, 2002.
    https://doi.org/10.4184/jkss.2002.9.4.322
    Copyright © 2002 Korean Society of Spine Surgery
    Original Article

    Comparative Study of Arthroscopic and Microscopic Discectomy of Lumbar Disc Herniation in Teenagers

    Jae Yoon Chung, M.D., Hyoung Yeon Seo, M.D. and Hyun Jong Kim, M.D.
      • Department of Orthopaedics, Chonnam National University Hospital, Gwangju, Korea.
    • Address reprint requests to Jae Yoon Chung, M.D. Department of Orthopaedic Surgery, Chonnam National University Hospital, Hak Dong 8, Gwangju 501-757, Korea. Tel: 82-62-220-6336, Fax: 82-62-225-7794, Email: jychung@chonnam.ac.kr

    Abstract

    Purpose

    To compare clinical results and radiologic changes after arthroscopic and microscopic discectomy of lumbar disc herniation in teenagers who have no degenerative change.

    Materials and Methods

    From Jan 1990 to Aug 2001. 70 lumbar disc herniations were performed in patients below 20 years old who were admitted to our department, among these 67 cases (49:male, 18:female) were evaluated for at least 1 year. Their average age was 18.1 years (13~20 years). Forty-six received microscopic discectomy and 21 arthroscopic discectomy. Mean follow-up duration was 26.4 months (12~88 months).

    Results

    Clinical results and disc height change were compared between the arthroscopic and microscopic discectomy groups using the criteria of MacNab, and the relationship between disc height change and clinical results, excised disc volume, operative technique, body mass index and symptom duration were investigated. Clinically there was no significant difference between the two groups (p=0.425), and their results were the same as those of adults. At the 1 year-follow up, disc height changes showed no correlation with the method of operation (p=0.996) or the volume of the excised disc. Postoperative disc height in teenagers of lumbar disc herniation who showed no degenerative change significantly decreased with time, but no significant relation was observed between disc height changes and clinical results, operative technique, excised disc volume, body mass index, involved disc site or symptom duration between the two groups.

    Conclusion

    We believe that arthroscopic discectomy is an effective method, if the patients status permits, because it has the advantages of non-invasiveness, short hospitalization period and earlier return to normal life.

    Keywords
    Lumbar spine; Lumbar disc herniation; Arthroscopic disc excision; Microscopic disc excision; Teenager

    Figures

    Fig. 1
    Comparison of LBP score change between arthroscopic and microscopic discectomy.

    Fig. 2
    Comparision of mean disc height change between arthroscopic and microscopic discectomy. (by Farfan's method)

    Fig. 3
    Comparison of changes of VAS(visual analogue scale) between arthroscopic and microscopic discectomy.

    Fig. 4
    14-years-old female with Rt leg radiating pain. Preoperative MRI (A) showed the protruded disc herniation at L4-5. Lateral radiograph at 24 months follow-up after arthroscopic disc excision (C) showed decreased disc height in comparision with preoperative radiograph (B).

    Fig. 5
    17-years-old male with Rt leg radiating pain and positive straight leg raising. Preoperative MRI (A) showed the extruded disc herniation at L4-5. Lateral radiograph at 26 months follow-up after microscopic disc excision (C) showed decreased disc height in comparision with preoperative radiograph (B).

    Tables

    Table 1
    Objective clinical results of Arthroscopic & Mircoscopic discectomy

    Table 2
    Comparison of the clinical results between Arthroscopic and Microscopic discectomy groups (by Macnab's criteria)

    Table 3
    Comparison of mean disc height change between Arthroscopic and Microscopic discectomy (by Farfan's method)

    Table 4
    Subjective clinical results of Arthroscopic and Microscopic discectomy

    Table 5
    Complication of Arthroscopic and Microscopic discectomy

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    MeSH Terms
    Adolescent*
    Adult
    Body Mass Index
    Diskectomy*
    Follow-Up Studies
    Hospitalization
    Humans
    Young Adult
    Metrics
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