Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes

Background Data: Upper lumbar disc herniation involving D12/L1, L1/L2, and L2/L3 levels is less prevalent than lower lumbar discs. In terms of clinical characteristics and surgical managements, they are different from those at the lower levels of the lumbar spine. Spinal canals are narrower than tho...

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Autores principales:	Ahmed Faisal Toubar, Medhat ElSawy
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2019
Materias:	Upper lumbar spine facetectomy transpedicular fixation degenerative disc disease Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/d539d048c3f348408bdc9d037bbf0627
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spelling	oai:doaj.org-article:d539d048c3f348408bdc9d037bbf06272021-12-02T06:11:23ZHerniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes2314-89502314-8969https://doaj.org/article/d539d048c3f348408bdc9d037bbf06272019-04-01T00:00:00Zhttps://esj.journals.ekb.eg/article_43539_59f4be16a63ca15a2bff1010df437052.pdfhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Upper lumbar disc herniation involving D12/L1, L1/L2, and L2/L3 levels is less prevalent than lower lumbar discs. In terms of clinical characteristics and surgical managements, they are different from those at the lower levels of the lumbar spine. Spinal canals are narrower than those of the lower levels, which may compromise multiple spinal nerve roots or conus medullaris with higher complication rate with surgical intervention. Purpose: To investigate the clinical features and surgical outcomes of patients operated on for upper lumbar disc herniations. Study Design: Retrospective clinical cohort study. Patients and Methods: This study included 20 patients diagnosed with herniated disc at upper levels (T12-L1, L1-L2, and L2-L3). Patients were operated on during the period between June 2015 to March 2017. All patients were operated on via transfacet approach with pedicle screw fixation. Postoperative data including clinical and neurological outcomes and radiographic imaging have been collected. Postoperative follow-up evaluation included immediate postoperative medical records and a postoperative visit to the outpatient clinic until 18 months postoperatively. Patients’ outcomes were assessed using Visual Analogue Scale of radicular and back pain and Oswestry Disability Index (ODI) as functional score. Results: Over a mean follow-up period of 13±2.5 months, there was significant improvement in radicular pain (P = 0.0026) and back pain (P = 0.049) and myelopathy and statistically significant improvement in Oswestry Disability Index (ODI) (P = 0.0032) compared to the preoperative value. No postoperative complications were detected in this series. Conclusion: This approach offers a safe technique for decompression and stabilization at lower thoracic and upper lumbar region. (2019ESJ178) Ahmed Faisal ToubarMedhat ElSawyEgyptian Spine AssociationarticleUpper lumbar spinefacetectomytranspedicular fixationdegenerative disc diseaseNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 30, Iss 1, Pp 23-30 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Upper lumbar spine facetectomy transpedicular fixation degenerative disc disease Neurology. Diseases of the nervous system RC346-429
spellingShingle	Upper lumbar spine facetectomy transpedicular fixation degenerative disc disease Neurology. Diseases of the nervous system RC346-429 Ahmed Faisal Toubar Medhat ElSawy Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes
description	Background Data: Upper lumbar disc herniation involving D12/L1, L1/L2, and L2/L3 levels is less prevalent than lower lumbar discs. In terms of clinical characteristics and surgical managements, they are different from those at the lower levels of the lumbar spine. Spinal canals are narrower than those of the lower levels, which may compromise multiple spinal nerve roots or conus medullaris with higher complication rate with surgical intervention. Purpose: To investigate the clinical features and surgical outcomes of patients operated on for upper lumbar disc herniations. Study Design: Retrospective clinical cohort study. Patients and Methods: This study included 20 patients diagnosed with herniated disc at upper levels (T12-L1, L1-L2, and L2-L3). Patients were operated on during the period between June 2015 to March 2017. All patients were operated on via transfacet approach with pedicle screw fixation. Postoperative data including clinical and neurological outcomes and radiographic imaging have been collected. Postoperative follow-up evaluation included immediate postoperative medical records and a postoperative visit to the outpatient clinic until 18 months postoperatively. Patients’ outcomes were assessed using Visual Analogue Scale of radicular and back pain and Oswestry Disability Index (ODI) as functional score. Results: Over a mean follow-up period of 13±2.5 months, there was significant improvement in radicular pain (P = 0.0026) and back pain (P = 0.049) and myelopathy and statistically significant improvement in Oswestry Disability Index (ODI) (P = 0.0032) compared to the preoperative value. No postoperative complications were detected in this series. Conclusion: This approach offers a safe technique for decompression and stabilization at lower thoracic and upper lumbar region. (2019ESJ178)
format	article
author	Ahmed Faisal Toubar Medhat ElSawy
author_facet	Ahmed Faisal Toubar Medhat ElSawy
author_sort	Ahmed Faisal Toubar
title	Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes
title_short	Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes
title_full	Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes
title_fullStr	Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes
title_full_unstemmed	Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes
title_sort	herniated disc at the upper lumbar region: surgical technique and clinical outcomes
publisher	Egyptian Spine Association
publishDate	2019
url	https://doaj.org/article/d539d048c3f348408bdc9d037bbf0627
work_keys_str_mv	AT ahmedfaisaltoubar herniateddiscattheupperlumbarregionsurgicaltechniqueandclinicaloutcomes AT medhatelsawy herniateddiscattheupperlumbarregionsurgicaltechniqueandclinicaloutcomes
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Herniated Disc at the Upper Lumbar Region: Surgical Technique and Clinical Outcomes

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