Two cases of lumbar disc herniation with a psychological problem.

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We treated two patients with lumbar disc herniation who also had a psychological problem.The first case was a 24-year-old male who complained of low back pain and numbness of right lower extremity. We diagnosed lumbar disc herniation of a level between lumbar five and sacrum. After conservative treatment, surgical treatment was performed consisting of extirpation of nucleus pulposus by Love's technique. After operation, the symptoms lessened but 3 weeks later, he again complained of severe low back pain. After six months, we performed a second operation. This was laminectomy of lumbar five. We continued conservative treatment. The symptoms decreased gradually.The second case was a 49-year-old female who complained of low back pain and numbness of right lower extremity. We diagnosed lumbar disc herniation of a level between lumbar four and five, lumbar five and sacrum. We treated her conservatively, because she had certain psychological factors. After long term treatment, the symptoms decreased gradually. In treatment of low back pain, we have to consider subjective and neurological symptoms, and also psychological factors.
西日本整形・災害外科学会の論文