Journal of Pediatric Orthopaedics - 2026-09-01 - Journal Article
Recovery Trajectory and Long-Term Outcomes After Lumbar Microdiscectomy in Adolescents: A 5-Year Longitudinal Study.
Kapetanakis S, Chatzivasiliadis M
Topics
Key Takeaway
Lumbar microdiscectomy in adolescents (n=26) produced durable improvement at 5 years, with ODI improving from 61.8 to 12.9 and EQ-5D from 0.456 to 0.942, with an 8% reoperation rate for recurrent herniation.
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Summary
This study evaluated patient-reported outcomes following lumbar microdiscectomy in adolescents aged 14–18 with LDH refractory to ≥6 weeks of conservative treatment. VAS leg pain dropped from 8.3 to 1.2, ODI from 61.8 to 12.9, and EQ-5D rose from 0.456 to 0.942 at final follow-up, with the majority of recovery occurring within the first 3–6 months and remaining stable through 5 years. No perioperative complications occurred, and 2 patients (8%) required reoperation for recurrent herniation.
Key Limitation
The sample size of 26 patients from a single center precludes generalizability and renders the 8% reoperation rate statistically imprecise, with wide confidence intervals that could meaningfully alter clinical counseling.
Original Abstract
BACKGROUND
Symptomatic lumbar disc herniation (LDH) requiring surgery is uncommon in adolescents, and available outcome data are limited compared with adult populations. Although lumbar microdiscectomy is generally associated with favorable short-term results, information regarding the long-term durability of clinical improvement and the trajectory of recovery in this age group remains scarce. The purpose of this study was to evaluate long-term patient-reported outcomes and recovery patterns following lumbar microdiscectomy for adolescent LDH.
METHODS
A retrospective analysis of prospectively collected data was performed for consecutive patients between 14 and 18 years old who underwent microdiscectomy for symptomatic LDH refractory to ≥6 weeks of conservative treatment. Pain (VAS leg/back), disability (ODI), and quality of life (EQ-5D) were assessed preoperatively and at 1, 3, 6, and 12 months and at a minimum of 60 months postoperatively. Longitudinal changes were analyzed using linear mixed-effects models with Holm-adjusted comparisons versus baseline. Complications and reoperations were recorded.
RESULTS
Twenty-six adolescents (mean age 15.7±1.8 y) with complete ≥60-month follow-up were included. Significant improvement was observed for all outcomes ( P <0.001). Mean VAS leg pain improved from 8.3 to 1.2 and VAS back pain from 6.0 to 1.0 at final follow-up. ODI improved from 61.8 to 12.9, and EQ-5D increased from 0.456 to 0.942. The greatest improvement occurred within the first 3 to 6 months and remained stable thereafter. No perioperative complications were observed. Two patients (8%) required reoperation for recurrent herniation.
CONCLUSIONS
Lumbar microdiscectomy provides rapid and durable clinical improvement in adolescents with LDH. Most recovery occurs early and remains stable through 5 years, supporting microdiscectomy as a reliable treatment option in appropriately selected patients.
LEVEL OF EVIDENCE
Level IV-therapeutic study (retrospective case series of prospectively collected data).