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Upper lumbar disc herniation.

Herniations of the upper lumbar disc have often been overlooked due to a relatively low incidence we had 457 lumbar disc surgeries from January 1978 to June 1987. Twenty-two of them were of the upper three lumbar discs. We analyzed these patients according to their clinical syndromes, radiological findings and surgical results. The characteristic features of anterior thigh pain from upper lumbar disc herniation were different from the more commonly seen fourth and fifth lumbar disc herniation which resulted in sciatica. The incidence of cauda equina syndrome was relatively high in our series (36%). All the 22 cases had correlated X-ray findings. Satisfactory operative results for upper lumbar disc herniation were achieved in 20 of 22 (90%).