Comparison of Adolescents with Adults in Lumbar HNP

Park, Heui Jeon; Lee, Doo Hee; Lee, Sei Young

Abstract

PURPOSE: To evaluate the difference of clinical and radiological findings for patients who underwent surgery for lumbar HNP in adolescents and adults
MATERIALS AND METHODS
We studied 70 patients ; 35 adolescents(below 20 years of age), 35 adults(21 to 40 years of age) retro-spectively from May 1992 through July 1999, whom we were able to follow up for more than one year after surgery. Patients with spinal instability and stenosis were excluded.
RESULTS
By the JOA score, preoperative radiating pain of the lower leg was 1.0 point in adolescents, 0.6 point in adults, showing a statistically significant difference(p<0.05). Mean value was excellent as 9.5 points in adolescents and 9.3 points in adults at last follow-up of the JOA score, and there was no significant difference. Degree of disc degeneration was of higher grade in adults, but disc degeneration was not related to lower back pain in either group. In adolescents, severity of preoperative sensory or motor dysfunction affected duration of postoperative sensory or motor recovery respectively, while in adults, severity of either preoperative sensory or motor dysfunction affected that of both sensory and motor postoperative neurologic recovery(p<0.05). The longer the time of suffering from radiating pain, the lower the points of last follow-up JOA score in adolescents. The longer the time of lower back pain, the lower the points in adults(p<0.05).
CONCLUSION
Preoperative radiating pain was more severe in adults, and no other clinical difference was seen between the two groups. In adolescents, severity of preoperative sensory or motor dysfunction affected duration of postoperative sensory or motor recovery respectively, while in adults, severity of either preoperative sensory or motor dysfunction affected that of both sensory and motor postoperative neurologic recovery. Duration of radiating pain in adolescents, and lower back pain in adults, can be used to predict prognosis.