Abstract:

        Objective  To evaluate the clinical significance and surgical results of lumbar disc herniation associated with separated ring epiphysis in adolescents.  Methods  From September 1998 to March 2009, 82 cases（range 9～20y，mean 15.9 y）of adolescent lumbar disc herniation were reviewed by clinical data and CT. 22 cases of lumbar disc herniation associated with separated ring apophysis was group A. Location, size, and shape were analyzed. Discectomy and separate ring apophysis resection were carried out at the same time. 30 in 60 cases with disc herniation were group B, and discectomy was performed only. JOA and VAS were used for clinical evaluation. Clinical features and surgical outcomes were compared between group A and group B. Results   22 cases (28％) suffered from lumbar disc herniation associated with separated ring apophysis. Clinical symptom and neurological status of group A were more serious than that of group B according to VAS and JOA（P＜0.05）. Pre-operative endurable periods of group A was shorter than that of group B significantly（P＜0.05）. There was no significant difference between the two groups regarding post-operative results by JOA and VAS（P＞0.05）. Operation time and blood lost were much higher in group A（P＜0.05）. Conclusions Adolescent lumbar disc herniation associated with separated ring apophysis with more serious symptoms should be performed operation when diagnosis was determined. Bone block resection should be carried out when performing discectomy for sequestrated, large, central type, or lateral recess separated bone.

Key words: Adolescents, Lumbar disc herniation, Separation of the ring apophysis