A Retrospective Study of Adolescent Disc Herniation: Conservative Versus Surgical Management

Background Lumbar disc herniation (LDH) is rare in adolescents, with an incidence of 1-5% in individuals under 20 years of age. The condition often manifests as radiculopathy, with or without back pain, posing diagnostic challenges due to differential diagnoses like musculoskeletal disorders. While conservative management is the first-line approach for most patients, surgical intervention is recommended for severe cases or when conservative measures fail. Objectives This study aimed to compare functional outcomes in adolescent patients with symptomatic LDH treated conservatively versus surgically. Methods A retrospective study was conducted at R.L. Jalappa Hospital, Kolar, India, between May 2023 and April 2024. The study included 44 patients aged 10-19 years with MRI-confirmed LDH. Participants were divided into two groups: conservative management (n = 22) and surgical management (n = 22). Visual analog scale (VAS) and Oswestry Disability Scale (ODS) were used to assess outcomes. Statistical analysis was performed using independent t-tests and chi-square tests, with a significance threshold of p < 0.05. Results The mean age was 15.95 ± 0.844 in the conservative group and 16.00 ± 0.816 in the surgical group, with equal gender distribution. VAS scores before and after management showed no significant difference between the groups (p = 0.898 and p = 1.000, respectively). ODS scores after management were significantly better in the surgical group (p = 0.024). Complications were minimal and comparable (p = 0.709). Conclusion Both conservative and surgical management effectively reduced pain in adolescent LDH patients, but surgical management demonstrated superior functional outcomes. Complication rates were low and comparable. Further studies with larger sample sizes and longer follow-up are recommended.