[Diagnosis and surgery of lumbar disc herniation sequestrating to upper spinal canal: analysis of 17 cases].

OBJECTIVE

To summarize the experience in diagnosis and surgery of lumbar disc herniation sequestrating to upper spinal canal.

METHODS

Seventeen patients, 9 males and 8 females, aged 41 (27-54), with the diseased intervertebral discs herniated and upward sequestrated that were confirmed by lumbar MRI, all with definite clinical manifestations of nerve root compression, underwent operation, including 14 cases undergoing semi-laminectomy and discectomy and 3 cases undergoing laminectomy, discectomy, and fusion. Japanese Orthopedic Association (JOA) (29 scores) evaluation standard was used to before the operation and 14 days and 3 months after the operation to evaluate the curative effects.

RESULTS

The average operation time was 80 min 50-180 min), and the average blood loss was 170 ml (20-350 ml). Cerebrospinal fluid leakage occurred after operation in 2 cases. The JOA score was 6.7 pre-operationally, and then rose to 24.214 days and 26.53 months post-operationally. The clinical effect was satisfied.

CONCLUSION

Lumbar disc herniation sequestrating to upper spinal canal is often misdiagnosed as intraspinal tumor. Confirmed diagnosis depends on the operators' experience and intensive MRI. Operation is necessary for this type of lumbar disc herniation. Lumbar stability must be considered during decompression and discectomy.