THE OUTCOME OF TREATMENT FOR LUMBAR INTERVERTEBRAL DISC DISEASE IN TWO GROUPS OF ADOLESCENTS: THOSE WHO PLAY HIGH-LEVEL SPORTS AND THOSE WHO DON’T

Abstract

Objective: To evaluate the outcome of treatment for adolescent disc disease (ADD) in individuals regularly involved in high class sport compared to relatively more sedentary adolescents.

Design: Retrospective observational study.

Setting: Private Spinal Orthopaedic Practice.

Patients: 52 individuals with confirmed ADD. 25 competing at county or national level in various sports (Group A). 27 moderately active individuals (Group B), but not elite sports players.

Interventions: History and clinical examination followed by radiological investigations were performed. Both groups were treated with oral medication including simple analgesia, muscle relaxants and NSAIDs as well as physiotherapy. Those with persistent pain were referred for pain management. Surgery was considered for refractory cases.

Main outcome measurements: The clinical and radiological evidence of disease progression, need for minimally invasive and invasive treatments as well as return to previous level of sport.

Results: 11 patients (44%) in group A had a non-invasive programme of treatment based on intensive physiotherapy. 11 (44%) needed minimally-invasive treatments in addition to physiotherapy. Three patients (12%) required surgery. One patient had to give up elite sport because of recurrent pain on significant exercise, but the others resumed their previous level of activity.

Nine patients (33%) in Group B were treated by physiotherapy alone while 13 (48%) had minimally-invasive treatment in addition to physiotherapy. Five patients (18.5%) required surgery. Two patients required revision surgery. All patients returned to their normal level of sporting activity.

Conclusion: Adolescents who play sport at a high level should not be discouraged by a diagnosis of ADD, as the outcomes of treatment are at least no worse than in their less active counterparts.