Outcome of symptomatic upper lumbar disc herniation

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Upper lumbar disc herniations (LDH) present unique challenges, including a higher risk of neural compromise and cauda equina syndrome.
• These conditions often necessitate surgical intervention, despite variable surgical outcomes.
• Assessing the efficacy of surgical management for upper LDH is crucial for patient care.

Purpose of the Study:

• To evaluate the clinical and functional outcomes of surgical treatment for symptomatic upper lumbar disc herniations.
• To analyze patient data over a decade (July 2003 to June 2012) to determine surgical success rates.

Main Methods:

• Retrospective review of 123 patients (30-69 years) who underwent upper lumbar discectomy.
• Analysis of surgical time, blood loss, Visual Analogue Score (VAS) for pain, Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) Score, and MacNab's criteria.
• Statistical analysis using Chi-squared and z-tests (SPSS) to assess outcome improvements.

Main Results:

• No significant difference in operative time or blood loss was observed.
• Significant improvements were noted in pain, sensory and motor function, reflexes, VAS, ODI, and all JOA components (p<0.05).
• Overall satisfactory outcomes were achieved in 83.74% of cases, with manageable postoperative complications (8.13%).

Conclusions:

• Symptomatic upper lumbar disc herniations can be effectively treated with surgery, yielding satisfactory clinical and functional results.
• Careful surgical decision-making is key to achieving positive outcomes in upper LDH cases.
• Despite intra-operative complications (20.32%), surgical intervention demonstrates a high success rate for upper LDH.