Recovery Trajectory and Long-Term Outcomes After Lumbar Microdiscectomy in Adolescents: A 5-Year Longitudinal Study

BACKGROUND: Symptomatic lumbar disc herniation (LDH) requiring surgery is uncommon in adolescents, and available outcome data are limited compared with adult populations. Although lumbar microdiscectomy is generally associated with favorable short-term results, information regarding the long-term durability of clinical improvement and the trajectory of recovery in this age group remains scarce. The purpose of this study was to evaluate long-term patient-reported outcomes and recovery patterns following lumbar microdiscectomy for adolescent LDH. METHODS: A retrospective analysis of prospectively collected data was performed for consecutive patients between 14 and 18 years old who underwent microdiscectomy for symptomatic LDH refractory to ≥6 weeks of conservative treatment. Pain (VAS leg/back), disability (ODI), and quality of life (EQ-5D) were assessed preoperatively and at 1, 3, 6, and 12 months and at a minimum of 60 months postoperatively. Longitudinal changes were analyzed using linear mixed-effects models with Holm-adjusted comparisons versus baseline. Complications and reoperations were recorded. RESULTS: Twenty-six adolescents (mean age 15.7±1.8 y) with complete ≥60-month follow-up were included. Significant improvement was observed for all outcomes ( P <0.001). Mean VAS leg pain improved from 8.3 to 1.2 and VAS back pain from 6.0 to 1.0 at final follow-up. ODI improved from 61.8 to 12.9, and EQ-5D increased from 0.456 to 0.942. The greatest improvement occurred within the first 3 to 6 months and remained stable thereafter. No perioperative complications were observed. Two patients (8%) required reoperation for recurrent herniation. CONCLUSIONS: Lumbar microdiscectomy provides rapid and durable clinical improvement in adolescents with LDH. Most recovery occurs early and remains stable through 5 years, supporting microdiscectomy as a reliable treatment option in appropriately selected patients. LEVEL OF EVIDENCE: Level IV-therapeutic study (retrospective case series of prospectively collected data).