%0 Journal Article
%T Full-endoscopic lumbar discectomy for lumbar disc herniation in young adults: 199 consecutive cases treated by a single surgeon with a mean 3.7-year follow-up.
%A Feng F
%A Zhao R
%A Dong H
%A Yu L
%A Yang Y
%A Tang H
%A Liu X
%A Zhu B
%J J Neurosurg Spine
%V 41
%N 3
%D 2024 Sep 1
%M 38941631
%F 3.467
%R 10.3171/2024.4.SPINE231011
%X <B>OBJECTIVE: </B>Lumbar disc herniation (LDH) is rare in young adults. The present study aimed to evaluate the clinical outcomes of full-endoscopic lumbar discectomy (FELD) for LDH in young adults and to determine the risk factors that predict unfavorable outcomes of FELD for LDH in young adults.<BR><B>METHODS: </B>A retrospective two-center cohort study was performed between January 2015 and October 2021 at the authors' institutions. Clinical outcomes were assessed using the visual analog scale (VAS) for low-back pain and leg pain and the Oswestry Disability Index (ODI). The modified Macnab criteria were used to evaluate clinical efficacy at the last follow-up, and the global outcomes were classified into 4 groups, namely excellent, good, fair, and poor. The fair and poor groups were defined as unfavorable outcomes.<BR><B>RESULTS: </B>One hundred ninety-nine patients were analyzed in this study (mean age 18.5 years, mean BMI 25.1 kg/m2, male/female sex ratio 2.8). The duration from the onset of symptoms to the operation was in general prolonged with age. The VAS and ODI scores significantly improved after surgery. A total of 17 of 195 single-segment cases had unfavorable outcomes based on the modified Macnab criteria. Lateral disc herniation (OR 3.72, 95% CI 1.14-12.12, p = 0.029) and high preoperative VAS score (OR 1.98, 95% CI 1.13-3.46, p = 0.017) were identified as risk factors for unfavorable outcomes after FELD.<BR><B>CONCLUSIONS: </B>FELD for LDH in young adults is safe and effective. Preoperative VAS score and lateral disc herniation are risk factors of nonfavorable outcomes after surgery and may be a useful index for surgical procedure selection.