Abstract：
Lumbar disc herniation (LDH) is rare in juveniles. LDH occurring at age 20 years or younger is referred to as juvenile disc herniation (JDH). While adult LDH is regarded as an advanced stage of disc degeneration, it remains unclear why intervertebral discs rupture in youth. This study aimed to characterize magnetic resonance imaging (MRI) findings of JDH and investigate possible etiological factors. From 2013 to 2020, JDH patients and controls were identified and interviewed to assess demographics, general lifestyles, and family histories. MRIs were evaluated for disc degeneration, epiphyseal ring separation, Modic changes and endplate lesions. The relationships between JDH and suspected risk factors were examined. A total of 297 JDH patients (199 boys and 98 girls, age 17.3 ± 2.1 years) and 185 controls (age 17.1 ± 2.4 years) were studied. Age, body mass index, exposures to daily physical labor, regular exercise, and daily sitting time were similar between JDH cases and controls. A family medical history of serious back pain was more common in JDH patients than in controls (59.4% vs. 26.5%, p < 0.001), as well as family history of clinically established LDH (45.0% vs. 12.4%, p < 0.001). Epiphyseal ring separation was identified in 102 (29.2%) herniated discs in 91 (36.4%) JDH patients, while occurring in only 5 (1.4%) control participants (p < 0.001). Overall, severe disc degeneration was not a prominent finding in JDH patients. In conclusion, epiphyseal ring separation was a common magnetic resonance feature in JDH. Findings suggest a genetically mediated developmental model of JDH, rather than a model of premature disc degeneration.
摘要：
腰椎间盘突出症（LDH）在青少年中很少见。发生在20岁或更年轻的LDH被称为青少年椎间盘突出症(JDH)。虽然成人LDH被认为是椎间盘退变的晚期，目前尚不清楚为什么青少年椎间盘破裂。本研究旨在描述JDH的MRI表现并探讨可能的病因。从2013年到2020年，对JDH患者和对照进行了识别和访谈，以评估人口统计学，一般的生活方式和家族史。MRI评估椎间盘退变，骨phy环分离，Modic改变和终板病变。检查了JDH与可疑危险因素之间的关系。共有297名JDH患者(199名男孩和98名女孩，年龄17.3±2.1岁）和185名对照（年龄17.1±2.4岁）进行了研究。年龄,BMI,暴露于日常体力劳动，定期锻炼,JDH病例和对照组的每日坐姿时间相似。与对照组相比，JDH患者有严重背痛的家族史更为常见（59.4％vs26.5％，P<0.001)，以及临床确定的LDH家族史(45.0%vs12.4%，P<0.001)。在91例（36.4％）JDH患者中，102例（29.2％）突出的椎间盘中发现了骨phy环分离，而仅发生在5名（1.4%）对照参与者中（P<0.001）。总的来说,严重的椎间盘退变并不是JDH患者的突出发现.总之,骨phy环分离是JDH的常见MR特征。研究结果表明JDH的遗传介导发育模型，而不是早期椎间盘退变的模型。本文受版权保护。保留所有权利。
