Clinical Characteristics and Surgical Outcomes of High Lumbar Disc Herniations: A Single-center Series
Adrian Jamesraj Jacob, Arunava Gupta, Balamurugan Mangaleswaran, M. K. SaranrajBackground:
High lumbar disc herniations are uncommon and differ from lower lumbar disease due to distinct anatomical and biomechanical features, often leading to atypical presentations and variable surgical outcomes.
Objective:
To analyse the clinical characteristics and short-term surgical outcomes of high lumbar disc herniations.
Methods:
This retrospective single-centre study included 39 consecutive patients who underwent surgery for disc herniation at L1 -2, L2 -3, or L3 -4 between 2019 and 2025. Demographic, clinical, radiological, and surgical data were reviewed. Pain severity was assessed using the Visual Analogue Scale (VAS) preoperatively and at 3 months postoperatively. Pre- and postoperative VAS scores were compared using the Wilcoxon signed-rank test. Subgroup analyses comparing true upper lumbar (L1 -2/L2 -3) versus L3 -4 herniations, and patients with versus without preoperative motor weakness, were performed using the Mann -Whitney U test.
Results:
The cohort included 31 males and 8 females with a mean age of 53 years. Most herniations occurred at L3 -4 (66.7%). Mean VAS improved significantly from 60.5 ± 13.6 preoperatively to 14.4 ± 11.0 postoperatively (p < 0.001). There was no significant difference in VAS improvement between true upper lumbar and L3 -4 herniations (
Conclusion:
Surgical treatment of high lumbar disc herniations provides significant short-term pain relief, with comparable outcomes across levels and irrespective of preoperative motor weakness.