Department of Orthopedics, Capital Medical University, Beijing Chaoyang Hospital, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China.
BMC Musculoskelet Disord. 2024 Jun 15;25(1):470. doi: 10.1186/s12891-024-07588-7.
Upper lumbar disc herniation (ULDH) accounts for 1-10% of all lumbar disc herniations (LDH). This study aimed to evaluate the clinical characteristics and outcomes of patients with ULDH who underwent percutaneous transforaminal endoscopic discectomy (PTED) compared with those with lower LDH.
60 patients with ULDH or L4-L5 LDH treated with PTED between May 2016 and October 2021. MacNab criteria, visual analog scale (VAS) of back pain and leg pain, and Japanese Orthopedic Association (JOA) were evaluated before and after surgery.
In the L1-L3 group, 59.1% of the patients had a positive femoral nerve tension test, and 81.8% of the patients had a sensory deficit. Both groups showed significant improvements in VAS scores for low back and leg pain, and JOA scores postoperatively. No significant differences in the degree of improvement were observed between the two groups. The excellent/good rate was 81.8% in the L1-L3 group and 84.2% in the L4-L5 group, showing no significant difference.
PTED has comparable efficacy in treating ULDH as it does in treating lower LDH, it is a safe and effective treatment method for ULDH.
上腰椎间盘突出症（ULDH）占所有腰椎间盘突出症（LDH）的 1-10%。本研究旨在评估经皮椎间孔内窥镜椎间盘切除术（PTED）治疗 ULDH 与治疗较低水平 LDH 的患者的临床特征和结果。
2016 年 5 月至 2021 年 10 月期间，60 例 ULDH 或 L4-L5 LDH 患者接受了 PTED 治疗。采用 MacNab 标准、腰背腿痛视觉模拟评分（VAS）和日本矫形协会（JOA）评分评估手术前后。
在 L1-L3 组中，59.1%的患者股神经张力试验阳性，81.8%的患者感觉缺失。两组患者的腰背腿痛 VAS 评分和 JOA 评分均有显著改善。两组患者的改善程度无显著差异。L1-L3 组优良率为 81.8%，L4-L5 组为 84.2%，无显著差异。
PTED 治疗 ULDH 与治疗较低水平 LDH 的疗效相当，是治疗 ULDH 的一种安全有效的治疗方法。
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