Our Summary

This study looked at the effectiveness of a less invasive back surgery called percutaneous endoscopic discectomy (PED) in teenagers with a condition known as lumbar disc herniation (LDH) - where a disc in the lower back bulges or breaks open. They compared the results of this surgery in teenagers with results from young adults who had the same procedure.

The study involved 19 teenagers and 38 young adults who had this type of surgery. They found that the results in teenagers were good and comparable to other types of back surgery. Additionally, the teenagers seemed to recover faster and better than the young adults.

They also found that having symptoms for a long time and having disc degeneration (breakdown of the discs in the back) were linked to worse outcomes after surgery, while patients with more severe disc issues had better outcomes.

The authors suggest that PED could be a good treatment option for teenagers with LDH, and that a less aggressive surgical approach and a conservative rehab program might be best. However, they note that more research is needed, particularly long-term studies.

FAQs

  1. What is percutaneous endoscopic discectomy (PED) and who can it benefit?
  2. How does the recovery time and effectiveness of PED compare between teenagers and young adults?
  3. What factors were found to affect the outcomes of the PED surgery?

Doctor’s Tip

A doctor might tell a patient considering discectomy that it can be an effective treatment option for lumbar disc herniation, especially in teenagers. They may also recommend a less aggressive surgical approach, like percutaneous endoscopic discectomy, and emphasize the importance of a conservative rehabilitation program for optimal outcomes. Additionally, they may advise the patient to address symptoms promptly and consider the severity of their disc issues when deciding on treatment. It is also important to note that more research is needed to fully understand the long-term effects of this surgery.

Suitable For

Patients who are typically recommended for discectomy are those who have not experienced relief from non-surgical treatments such as physical therapy, medication, and epidural steroid injections. They may have symptoms such as severe back or leg pain, weakness or numbness in the legs, difficulty walking or standing, and loss of bowel or bladder control. Additionally, patients with a confirmed diagnosis of lumbar disc herniation through imaging tests such as MRI or CT scan are usually considered for discectomy.

Timeline

Before a discectomy, a patient may experience symptoms such as lower back pain, leg pain, numbness, tingling, and weakness. They may undergo imaging tests such as MRI or CT scans to diagnose the issue and may try conservative treatments such as physical therapy, medications, and injections.

After a discectomy, the patient may experience some pain and discomfort at the surgical site. They will likely need to rest and gradually increase their activity level as advised by their healthcare provider. Physical therapy may be recommended to help improve strength and flexibility in the back. The patient will have follow-up appointments to monitor their progress and may need to make lifestyle changes to prevent future issues. Overall, the goal is for the patient to experience relief from their symptoms and improve their overall quality of life.

What to Ask Your Doctor

  1. What is a discectomy and how does it work?
  2. Is percutaneous endoscopic discectomy (PED) the best option for my condition?
  3. What are the potential risks and complications associated with a discectomy?
  4. What is the success rate of PED in teenagers compared to young adults?
  5. How long is the recovery process after a discectomy?
  6. Are there any alternative treatments or therapies I should consider before opting for surgery?
  7. What can I do to improve my chances of a successful outcome after surgery?
  8. Will I need physical therapy or rehabilitation after the procedure?
  9. Are there any long-term effects or considerations I should be aware of after having a discectomy?
  10. Are there any restrictions or limitations I should follow post-surgery to prevent future complications?

Reference

Authors: Chen Y, Song R, Huang W, Chang Z. Journal: J Neurosurg Pediatr. 2019 Feb 1;23(2):251-258. doi: 10.3171/2018.8.PEDS18442. Epub 2018 Nov 2. PMID: 30485217