title: Considerations for surgical treatment of patients with upper lumbar disc herniations.
abstract: Nine patients treated by surgery for upper lumbar disc herniations were reviewed. Of nine patients with upper lumbar disc herniations at the L1-L2 or L2-L3 level, five were treated by anterior procedures, whereas four underwent posterior procedures. Four of the five patients on whom anterior procedures were performed underwent additional spinal instrumentation using the Kaneda device and Z-plate system. Clinical symptoms improved in all nine patients. Confirmation of the type and level of disc herniation and increased thoracolumbar kyphosis must be taken into consideration when the optimal surgical procedure and spinal instrumentation method are selected.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Sakyoku, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ido
authors.forename: K
authors.initials: K
authors.lastname: Shimizu
authors.forename: H
authors.initials: H
authors.lastname: Tada
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuda
authors.forename: J
authors.initials: J
authors.lastname: Shikata
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012585:Sciatica / Q000209:etiology / Q000601:surgery; D013525:Surgical Instruments; D013514:Surgical Procedures, Operative / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome