Spinal canal dimensions affect outcome of adolescent disc herniation

PURPOSE Small spinal canal dimensions play a role in symptomatic adult disc herniation, but its role in adolescent disc herniation has not been investigated with MRI. The goal of this study was to examine retrospectively if there is a correlation with dimensions of osseous spinal canal and need of discectomy in an adolescent population suffering from disc herniation. METHODS A retrospective review of child and adolescent patients who were treated in our institution for back or back--related leg pain was conducted. Patients were divided in three groups; group 1: lumbar disc herniation requiring operative treatment; group 2: lumbar disc herniation treated with observation; and group 3: back pain and no disc herniation on MRI. MRI images and radiographs were studied for spinal canal dimensions and compared between groups. RESULTS The discectomy group presented considerably smaller spinal canal dimensions measured from the MRI images than the two other groups. CONCLUSION Adolescent patients requiring operative treatment for symptomatic disc herniation have smaller osseous spinal canals than patients who are managed non-operatively.