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Surgical Treatments for Lumbar Disc Disease in Adolescent Patients; Chemonucleolysis / Microsurgical Discectomy / PLIF with Cages

 Sung-Uk Kuh  ;  Young-Soo Kim  ;  Young-Eun Cho  ;  Young-Sul Yoon  ;  Byung-Ho Jin  ;  Keun-Su Kim  ;  Dong-Kyu Chin 
 YONSEI MEDICAL JOURNAL, Vol.46(1) : 125-132, 2005 
Journal Title
Issue Date
Adolescent ; Adult ; Child ; Diskectomy/instrumentation ; Diskectomy/methods* ; Follow-Up Studies ; Humans ; Intervertebral Disc Chemolysis* ; Intervertebral Disc Displacement/surgery* ; Intervertebral Disc Displacement/therapy* ; Lumbar Vertebrae/surgery* ; Microsurgery ; Spinal Fusion/instrumentation ; Spinal Fusion/methods* ; Treatment Outcome
Adolescent disc herniation ; lumbar chemonucleolysis ; microsurgical discectomy ; posterior lumbar interbody fusion (PLIF)
The herniated lumbar disc (HLD) in adolescent patients is characterized by typical discogenic pain that originates from a soft herniated disc. It is frequently related to back trauma, and sometimes it is also combined with a degenerative process and a bony spur such as posterior Schmorl's node. Chemonucleolysis is an excellent minimally invasive treatment having these criteria: leg pain rather than back pain, severe limitation on the straight leg raising test (SLRT), and soft disc protrusion on computed tomography (CT). Microsurgical discectomy is useful in the cases of extruded or sequestered HLD and lateral recess stenosis due to bony spur because the nerve root is not decompressed with chymopapain. Spinal fusion, like as PLIF, should be considered in the cases of severe disc degeneration, instability, and stenosis due to posterior central bony spur. In our study, 185 adolescent patients, whose follow-up period was more than 1 year (the range was 1 - 4 years), underwent spinal surgery due to HLD from March, 1998 to December, 2002 at our institute. Among these cases, we performed chemonucleolysis in 65 cases, microsurgical discectomy in 94 cases, and posterior lumbar interbody fusion (PLIF) with cages in 33 cases including 7 reoperation cases. The clinical success rate was 91% for chemonucleolysis, 95% for microsurgical disectomy, and 89% for PLIF with cages, and there were no nonunion cases for the PLIF patients with cages. In adolescent HLD, chemonucleolysis was the 1st choice of treatment because the soft adolescent HLD was effectively treated with chemonucleolysis, especially when the patient satisfied the chemonucleolysis indications.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Yoon, Young Sul(윤영설)
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
Jin, Byung Ho(진병호)
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