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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
Degenerative Disc Disease I: Introduction01:27

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Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
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The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...

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Related Experiment Video

Updated: Jul 10, 2026

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
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Decompression alone for 62 isolated L1-2 lumbar disc herniation.

Aydemir Kale1, Fatih Gok1, Tolga Turkmen2

  • 1Department of Neurosurgery, Gazi University Faculty of Medicine, Ankara, Turkey.

Surgical Neurology International
|March 5, 2026
PubMed
Summary

Open laminectomy/microdiscectomy (OLM) effectively treats rare upper lumbar disc herniations (L1-L2) without fusion. This surgical approach demonstrated adequate outcomes and no spinal instability in 62 patients.

Keywords:
Cauda equineL1-2MicrodiscectomySurgeryUpper lumbar disc herniation

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Orthopedics

Background:

  • Upper lumbar disc herniations (ULDHs) at the L1-L2 level are uncommon.
  • These herniations present surgical challenges due to the conus medullaris proximity.
  • Open laminectomy/microdiscectomy (OLM) without fusion is a potential treatment approach.

Purpose of the Study:

  • To evaluate the outcomes of open laminectomy/microdiscectomy (OLM) for L1-L2 disc herniations.
  • To assess the efficacy and safety of OLM in treating upper lumbar disc herniations.
  • To determine if OLM without fusion leads to spinal instability.

Main Methods:

  • Retrospective review of 62 patients undergoing OLM for L1-L2 disc herniations between 2005 and 2022.
  • Analysis included demographic data, Visual Analog Scale (VAS) for leg pain, and Modified Japanese Orthopaedic Association (mJOA) scores.
  • One-year postoperative dynamic X-rays were used to assess spinal stability.

Main Results:

  • L1-L2 disc herniations represented 0.9% of all lumbar disc herniations reviewed.
  • Common symptoms included back pain (95%), leg pain (82%), cauda equina symptoms (64%), and neurogenic claudication (45%).
  • No disc recurrences or clinical/radiological signs of instability were observed postoperatively.

Conclusions:

  • Open laminectomy/microdiscectomy (OLM) is a viable surgical option for L1-L2 disc herniations.
  • The OLM technique provides adequate clinical outcomes for upper lumbar disc herniations.
  • OLM for L1-L2 disc herniations does not result in spinal instability.