Clinical Picture of Herniated Upper Lumbar Discs

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The incidence of herniated lumbar discs at the first, second, and third lumbar interspaces in our clinic was 6.6% of 226 lumbar disc herniation treated surgically from 1969 through 1978. There were three herniation at the second lumbar interspace, and thirteen at the third lumbar interspace.1) The majority of patients complained of back or lower extremity pain, frequently over the anterior surface of the thigh.2) The youngest patient was thirteen years of age and the oldest seventy-two.3) The psoas-stretch test was positive in four patients with herniation of the third lumbar disc, in one patient with herniation of the second lumbar disc. There was limitation of straight-leg raising in only each one.4) The knee jerk was reduced in 55.5% and ankle jerk was reduced in 33.3% of the patients with herniation of the third lumbar disc. But, one patient with herniation of the second lumbar disc had accelerated.5) In roentgenographic examination, two patients with herniation of the second lumbar disc and six patients with herniation of the third lumbar disc had narrowing of the lumbar intervertebral space.6) Follow-up studies were available from three months to seven years after operation. Eleven of thirteen cases with herniation of the third lumbar disc had excellent results. But, no excellent cases with herniation of the second lumbar disc were found.
西日本整形・災害外科学会の論文