title: An observational study on the outcome after surgery for lumbar disc herniation in adolescents compared with adults based on the Swedish Spine Register.
abstract: BACKGROUND
  Disc-related sciatica has a prevalence of about 2% in adults, but is rare in adolescents. If conservative treatment is unsuccessful, surgery is an option.
  
  
  OBJECTIVE
  The aim of this study was to compare the outcomes of surgery for lumbar disc herniation in adolescents with adults in the Swedish Spine Register.
  
  
  METHODS
  This is a prospective observational study: National Quality Register.
  
  
  METHODS
  This study included 151 patients, 18 years or younger, 4,386 patients, 19-39 years, and 6,078 patients, 40 years or older, followed for 1-2 years after surgery.
  
  
  METHODS
  The primary outcomes were patient satisfaction and global assessment of leg and back pain. Secondary outcomes were Visual Analog Scale (VAS) leg pain, VAS back pain, Oswestry disability index (ODI), and EuroQol-5 dimensions (EQ-5D).
  
  
  METHODS
  Statistical analyses were performed with the Welch F test, the chi-square test, and the Wilcoxon signed-rank test.
  
  
  RESULTS
  At follow-up, 86% of the adolescents were satisfied compared with 78% in the younger adults and 76% in the older adults group (p<.001). According to the global assessment, significantly decreased leg pain was experienced by 87% of the adolescents, 78% of the younger adults, and 71% of the older adults (p<.001). Corresponding figures for back pain were 88%, 73%, and 70%, respectively (p<.001). All groups experienced significant postoperative improvement of VAS leg pain, VAS back pain, ODI, and EQ-5D (all p<.001).
  
  
  CONCLUSIONS
  The adolescent age group was more satisfied with the treatment than the adult groups. There was a significant improvement in all age groups after surgery.
authors.affiliation: Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Tobias
authors.initials: T
authors.lastname: Lagerbäck
authors.affiliation: Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences, Södersjukhuset, Karolinska Institutet, SE 118 83 Stockholm, Sweden; Department of Orthopaedics, Södersjukhuset, SE 118 83 Stockholm, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Elkan
authors.affiliation: Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Möller
authors.affiliation: Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden; Department of Orthopaedics, Sundsvall and Härnösand County Hospital, SE 851 86 Sundsvall, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Grauers
authors.affiliation: Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Elias
authors.initials: E
authors.lastname: Diarbakerli
authors.affiliation: Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden. Electronic address: paul.gerdhem@karolinska.se.
authors.forename: Paul
authors.initials: P
authors.lastname: Gerdhem
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000601:surgery*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D012042:Registries; D012585:Sciatica / Q000601:surgery*; D013548:Sweden; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adolescents; Discectomy; Lumbar disc hernia; Outcome; Surgery