I Yüce1, O Kahyaoğlu2, P Mertan3, H Çavuşoğlu4, Y Aydın5. 1. Acıbadem Mehmet Ali Aydınlar University, Vocational School of Health Services, Kayışdağı Caddesi No 32, Ataşehir, İstanbul, Turkey. Electronic address: dr.ismailyuce@gmail.com. 2. Acıbadem Healthcare Group, Fulya Hospital, Dikilitaş Mahallesi, Hakkı Yeten Cd. N(o) 23, Beşiktaş, Istanbul, Turkey. Electronic address: drokinova@hotmail.com. 3. Ruprecht-Karls University of Heidelberg, Medical Faculty, Heidelberg, Germany. Electronic address: pelinmertan@yahoo.com.tr. 4. Acıbadem Mehmet Ali Aydınlar University, Vocational School of Health Services, Kayışdağı Caddesi No 32, Ataşehir, İstanbul, Turkey. Electronic address: anhcavusoglu@yahoo.com. 5. Acıbadem Healthcare Group, Fulya Hospital, Dikilitaş Mahallesi, Hakkı Yeten Cd. N(o) 23, Beşiktaş, Istanbul, Turkey. Electronic address: ynaydin@gmail.com.
Abstract
BACKGROUND: Upper lumbar disc herniation (ULDH) is described mostly in levels L1-2, L2-3 and L3-4 of the lumbar spine in the literature and accounts for less than 10% of all disc herniations. The aim of our study was to evaluate the clinical characteristics and surgical results of ULDH. METHODS: In all, 367 patients treated for upper lumbar disc herniation and 2137 treated for lower lumbar disc herniation (LLDH) between January 2008 and January 2017 were included. They were followed up postoperatively at 12 months by radiological investigations, back and leg pain Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI). Preoperative data comprised age group (20-40, 40-60, 60-80 years), gender (male, female), lumbar level (L1-2, L2-3, L3-4), side of disc herniation (left, right) and symptom duration (0-3, 3-6, 6-9 months). RESULTS: ODI and VAS scores improved significantly postoperatively for all patients. Of the 367 ULDH patients, 169 were female (54%) and 198 male (46%), with a mean age of 55.8±10.1 years (range, 35-71). In 174 (47.4%) patients symptom duration was 3 months, in 99 (27.0%) 3-6 months, and in 94 (25.6%) 6-9 months. At 12 months, ODI, back and leg pain VAS scores showed a significant difference in improvement according to ULDH symptom duration<3 months and to LLDH symptom duration<6 months. CONCLUSION: Microdiscectomy in ULDH provided sufficient and safe decompression of neural structures, with significant reduction in symptoms and disability. We suggest that early surgical treatment is an important factor for good outcome in ULDH.
BACKGROUND: Upper lumbar disc herniation (ULDH) is described mostly in levels L1-2, L2-3 and L3-4 of the lumbar spine in the literature and accounts for less than 10% of all disc herniations. The aim of our study was to evaluate the clinical characteristics and surgical results of ULDH. METHODS: In all, 367 patients treated for upper lumbar disc herniation and 2137 treated for lower lumbar disc herniation (LLDH) between January 2008 and January 2017 were included. They were followed up postoperatively at 12 months by radiological investigations, back and leg pain Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI). Preoperative data comprised age group (20-40, 40-60, 60-80 years), gender (male, female), lumbar level (L1-2, L2-3, L3-4), side of disc herniation (left, right) and symptom duration (0-3, 3-6, 6-9 months). RESULTS:ODI and VAS scores improved significantly postoperatively for all patients. Of the 367 ULDH patients, 169 were female (54%) and 198 male (46%), with a mean age of 55.8±10.1 years (range, 35-71). In 174 (47.4%) patients symptom duration was 3 months, in 99 (27.0%) 3-6 months, and in 94 (25.6%) 6-9 months. At 12 months, ODI, back and leg pain VAS scores showed a significant difference in improvement according to ULDH symptom duration<3 months and to LLDH symptom duration<6 months. CONCLUSION: Microdiscectomy in ULDH provided sufficient and safe decompression of neural structures, with significant reduction in symptoms and disability. We suggest that early surgical treatment is an important factor for good outcome in ULDH.