LONG-TERM OUTCOME OF LUMBAR DISKECTOMY IN CHILDREN AND ADOLESCENTS 16YEARS OF AGE OR YOUNGER

We retrospectively reviewed the cases of seventy-two consecutive patie nts who had a lumbar discectomy, between 1950 and 1983, when they were sixteen years of age or younger, There were forty boys and thirty-two girls, At the time of the lumbar discectomy, twelve patients (17 per cent) also had a spinal arthrodesis, The mean duration of follow-up wa s 27.8 years (range, twelve to forty-five years). Twenty patients (28 per cent) had one reoperation or more, with the first reoperation perf ormed at a mean of 9.7 years after the initial discectomy, Fourteen pa tients had one reoperation, four had two reoperations, one had three, and one had five. Fifty-two patients (72 per cent) did not need a reop eration. At the time of the latest follow-up, forty-eight (92 per cent ) of the fifty-two patients either had no pain or had occasional pain related to strenuous activity and fifty-one (98 per cent) could partic ipate in daily activities with no or mild limitations. Survivorship an alysis showed that the overall probability that a patient would not ne ed a reoperation was 80 per cent at ten years and 74 per cent at twent y years after the initial operation. With the numbers available for st udy, we could not show that age, gender, or an arthrodesis performed a t the time of the initial operation were risk factors for a reoperatio n. We could not detect a difference, with respect to pain or the level of activity between the patients who had had an arthrodesis at the in itial operation and those who had not or between those who had a coexi sting structural abnormality of the lumbar spine and those who did not .