title: [Percutaneous endoscpic lumbar discectomy for the treatment of upper lumbar disc herniation].
abstract: OBJECTIVE
  To evaluate the preliminary clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) for patient with upper lumbar disc herniation and failing to respond to conservative treatment.
  
  
  METHODS
  From December 2008 to June 2011, 12 patients with upper lumbar disc herniation and failing to respond to conservative treatment were treated, including 8 males and 4 females, aged from 28 to 82 years old (averaged, 50.67 years old). Duration of upper lumbar disc herniation was 3 to 10 months, with an average of 5.75 months. MRI exam revealed 12 "degeneration discs" low in signal on T2 image, including 1 discs of T12L1, 1 of L1,2, 3 of L2,3 and 7 of L3,4. Discography showed positive response, fluoroscopy confirmed annulus fibrosus tears of posterior intervertebral disc in 12 discs. PELD was performed. Visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated before operation and after operation. The clinical outcome was determined by modified Macnab criteria at the final follow-up.
  
  
  RESULTS
  The average operation time of each patient was 1.45 h (ranged, 1.0 to 2.5 h), and the mean length of postoperative hospital stay was 5.83 days (ranged,4 to 9 days). There was no happening in ruptured meninges and nerve damage. Twelve patients were followed up,and the duration ranged from 1 to 12 months (averaged, 5.5 months). The VAS score decreased from preoperative 8.00 +/- 1.21 to postoperative 1.92 +/- 0.79 (P < 0.01). The ODI decreased from preoperative (78.81 +/- 13.65)% to the final follow-up (16.19 +/- 3.52)% (P < 0.01). According to the modified Macnab criteria, 3 patients got an excellent result, 8 good, 1 fair.
  
  
  CONCLUSIONS
  PELD is effective in treating patient with upper lumbar disc herniation failing to respond to conservative treatment.
authors: Department of Orthopaedics, Wuhu Hospital of Traditional Chinese Medicine, Wuhu 241000, Anhui, China.
authors: Sheng-Hua
authors: SH
authors: He
authors: Xiang
authors: X
authors: Zhao
authors: Xiao-Hai
authors: XH
authors: Wu
authors: Hao
authors: H
authors: Ding
authors: Jun
authors: J
authors: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017587:Diskectomy, Percutaneous / Q000379:methods*; D019723:Endoscopes; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged