Herniation of Upper Lumbar Disc: Clinical Finding & Surgical Result.
10.4184/jkss.2012.19.3.103
- Author:
Dong Eun SHIN
1
;
Chang Soo AHN
;
Duck Yun CHO
;
Hyung Ku YOON
;
Tae Hyung KIM
;
Jin Young BANG
;
Yoon Sik CHA
Author Information
1. Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University of Korea, Korea.
- Publication Type:Original Article
- Keywords:
Upper lumbar disc;
Herniation;
Operative treatment;
Results
- MeSH:
Diskectomy;
Femoral Nerve;
Incidence;
Knee;
Laminectomy;
Leg;
Low Back Pain;
Magnetic Resonance Imaging;
Prevalence;
Retrospective Studies;
Thigh
- From:Journal of Korean Society of Spine Surgery
2012;19(3):103-109
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A retrospective study. OBJECTIVES: We attempted to establish an efficient diagnosis and treatment modality by analyzing clinical manifestations and operative results of upper lumbar disc herniations. SUMMARY OF LITERATURE REVIEW: Upper lumbar disc herniations represented a lower incidence but have become easier to diagnose by predictable clinical aspects and an MRI scan. The operative results have been satisfactory. MATERIALS AND METHODS: We evaluated 41 cases, which were operated with posterior laminectomy and discectomy from September, 1996 to November, 2009. We analyzed pre-operative history, clinical and MRI findings, and then assessed operative results by Kim's criteria and functional change in the follow up. RESULTS: The prevalence of upper lumbar disc herniations in all disc herniations was 8.8%. Pre-operative manifestations were lower back pain (85.4%), radiating pain (80.5%), sensory deficit (53.7%), motor deficit (53.7%), and depressed knee jerk (65.9%). The positive rate of the femoral stretching test (78.0%) was higher than the straight leg raising test (39.0%). The VAS score changed from preoperative 9.0+/-0.8 into postoperative 1.4+/-1.3 points. The operative results were excellent or good in 82.9%. The rate of resuming previous work, including slight modification was 90.2%. CONCLUSIONS: Predictable clinical aspects of the upper lumbar disc herniations are anterior thigh pain with lower back pain, variable motor deficit, sensory deficit, depressed knee jerk and the positive femoral nerve stretching test. Through careful examination and radiological evaluations such as MRI, operative treatment can obtain a symptomatic improvement and satisfactory results.
