Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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L1-2 Disc Herniations : Clinical Characteristics and Surgical Results

  • Lee, Sang-Ho (Department of Neurosurgery, Gimpo Airport Wooridul Spine Hospital) ;
  • Choi, Seok-Min (Department of Neurosurgery, Spine Center, Myongji St. Mary's Hospital)
  • Published : 2005.09.28
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Abstract

Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

Keywords

References

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