Clinical Evalation of Upper and Middle Lumbar Radiculopathy.

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We report the clinical evaluation of upper and middle lumbar radiculopathy. Subjects comprised 6 male patients ranging in age from 48-75 years old with a mean of 62 years. The level of the radiculopathy was L1; 1 case, L2; 1 case, L3; 2 cases, L4; 2 cases. Clinically, almost patients complained of lumbago and, thigh or knee pain. Nerve root infiltration was most useful for diagnosis of the level.Two patients had partial laminectomy and 4 patients had osteoplastic laminectomy. Origin of the radiculopathy were disc herniation (sequestration type); 4 cases, OFL; 1 case, pedicular kinking; 1 case, disc herniation + facet; 1 case. The average length of follow-up was and the mean 19 months improvement rate according to the JOA-score was 68%.Anatomically, lumbar nerve roots of L1, 2, 3, 4 emerged lower to disc level compared with L5, S1 roots. Therefore, upper and middle lumbar nerve root radiculopathy is due to a variety of causes. We recommend osteoplastic laminectomy for treatment of upper and middle lumbar radiculopathies.
西日本整形・災害外科学会の論文