징병 신체검사에서 나타난 청소년기 추간반탈출증의 유병률과 임상적 특징

Abstract

Objective: The authors analyzed the large series of intervertebral disc herniation in adolescence to evaluate the prevalence, clinical characteristics, and possible risk factors on the basis of the data from the examinations for conscription. Materal and methods: Of 77685 nineteen-old-males who were given an examination for conscription at Regional Military Manpower Administration of Seoul in 2002, 382 patients exempted from conscription due to intervertebral disc herniation were analyzed. The diagnosis were made from the medical certificate, medical record, magnetic resonance imaging(MRI)(or computed tomography(CT)) which examinee presented and confirmed with the aid of reexamination of CT. Radiological characteristics and severity of intervertebral disc herniation as well as structural abnormalities of vertebral columns were carefully evaluated with CT scan and MRI scan. Possible risk factors like overweight, structural abnormality of vertebral column, trauma were analyzed statistically using one-sample T-test and chi-square test on the assumption that P value less than 0.05 was considered statistically significant. Result: Prevalence of intervertebral disc herniation in adolescence aged nineteen years and younger were 0.5%. L4-5 level was the most frequently affected site followed by L5-Sl. Of all 382 patients of intervertebral disc herniation, 29% were considered serious with reference to radiological evidence of root compression or significant discogenic spinal stenosis. Limbus fracture was found in 6.8% of patients. Overweight was the significant risk factor of the disease(p=0.0). However, neither structural abnormality of vertebral column nor trauma showed any relation to pathogenesis of intervertebral disc herniation. Conclusion: In adolescence aged nineteen years and younger, the prevalence of intervertebral disc herniation was 0.5% and accompanying limbus fracture was more frequent when compared with adult. Overweight was the only significant risk factor of the disease.