Analysis of MRI Findings of Adolescent Lumbar Disc Herniation (Comparision with Adult Lumbar Disc Herniation Findings)

Lee, Kyu Sung; Jeon, Seung Soo

Abstract

STUDY DESIGN: We compared the MRI and X-ray findings of adolescent lumbar disc herniation with that of adult.
OBJECTIVES
Purpose of study was to assess the different pathologic findings of adolescent lumbar disc herniation from adult in MRI and to predict the causes indirectly. SUMMARY OF LITERATURE REVEIWS: There are many debates about the causes of adolescent lumbar disc herniation, because disc herniation occurs before the degenerative changes of aging process of intervertebral disc. Trauma, structural anomalies and degenerative changes have been suggested as a cause
MATERIALS AND METHODS
We reviewed 29 adolescents and 36 adults with surgically proven lumbar disc herniation. Type of herniation, direction of herniation, severity of herniation, disc height, decrease of signal intensity, annular tear, facet asymmetry in MRI and associated spinal structural anomalies in plain X-ray were assessed. All of involved segments and operated segments were seperately analysed. Results were compared between two groups.
RESULTS
In adolescent group, definite degenerative changes such as decrease of signal intensity and annular tear of operated segments were found. Multiple levels were involved in adolescent as same with adult group.. All the findings showed no significant differences between two groups, but signal intensity of nucleus pulposus was severely decreased in adult group. In adolescent group, incidence of male and incidence of Schmorl's node were high which suggested that herniated disc has deep relationship with trauma. Facet asymmetry was more frequent in adolescent.
CONCLUSION
Pathologic premature degeneration presented already in adolescent disc herniation, and multiple level involvement suggested that underlying diathesis contributes to development of disc herniation, but degeneration of nucleus pulposus was severe in adult group. Trauma and facet asymmetry seem to be other factors in development of disc herniation.