The age significance of lumbar disc extrusion or sequestration: a systematic review of the literature.

Abstract

BACKGROUND CONTEXT : Surgery of lumbar disc extrusion or sequestration is usually reported in young adult. The significance of age has been underscored when one considers that lumbar disc herniation is the most common reason of spine surgery. Even if the procedure is non-life – threatening, a low risk of expected consequence would be far more devastating as a crisis occurring in this middle period of life. PURPOSE : To review the recent evidence for the significance of age at the time of surgery. STUDY DESIGN : Systematic review PATIENT SAMPLE: Patients who were performed surgery for lumbar disc herniation. OUTCOME MEASURES: Age of patients at the time performedt surgery for lumbar disc herniation. METHOD : A search of Medline, Embase, Cochrane database and cross references from 1980 to 2014 was conducted to identify the mean age of patients who underwent lumbar disc surgery. Two reviewers independently evaluated and extracted English published articles that contained keywords of lumbar disc herniation, extrusion and sequestration. Quality of evidence was classified into 3 levels. All of authors have no conflict of interest. RESULTS : There were totally 134 papers, 49 were excluded. Of all the 11,803 patients, 7,021 were male (59.48%) and 4,782 were female (40.52%) respectively with mean age of 41.75 years, age ranged from 18 to 96 years. All 85 articles were classified as 19 randomized controlled none concealed trials - level I, 34 prospective comparative studies - level II and 32 retrospective – level III evidence. CONCLUSION : Patients with proven damaged disc(s) are at greater risk to have lumbar discectomy at the age of 41.75 years.