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《Journal of Clinical Orthopaedics》 2008-04
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Clinical characteristics and selection of surgical treatment method for upper lumbar disc herniation

JIANG Yong-qing,DONG Da-ming,WANG Yan-song (Dept of Spinal Surgery,the 2nd Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150086,China)  
Objective To explore the clinical characteristics and diagnosing and treatment methods of the upper lumbar disc herniation.Methods 42 patients of upper lumbar disc herniation with significant low back pain were undergone X-ray test and partial intraspinal angiography,CT,MRI and EMG before surgery treatment.2 cases with bone graft fusion were resected lateral part of lesion vertebral lamina and process;2 cases were treated with contralateral interarticular process and vertebral lamina bone graft fusion;2 cases with intervertebral fusion were treated by laminectomy and arthrectomy of one side by posterior route and USS implantation;Other cases were treated with routine internal fixation.Results All patients were followed up for 1~3 years.5 cases got complications,of which 3 cases were with leakage of cerebrospinal fluid and 2 cases with cauda equina injury.According to the evaluation system of Nakano et al and Stauffer,the results were excellent in 35 cases,good in 5 and fair in 2,and the excellent and good rate was 95.2%.Conclusions The clinical manifestations of upper lumbar disc herniation are complicated.The approach of operation should be determined by the features of upper lumbar vertebrae anatomy and the site of herniation discs according to radiograph.
【CateGory Index】: R687.3
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