Upper lumbar disc herniation with only a few case reports available, especially at L1/2 and L2/3, is thought to be a rare disease. Eight consecutive patients, 7 males and one female, aged 29-65 years, with lumbar upper disc herniation were studied. Five had herniation at L1/2 and 3 at L2/3. In addition to lumbago, pain in the lower abdomen and around the inguinal and femoral region was found in all cases. Some cases were so severe as to give a false impression of acute abdomen. In 2 cases, paraplesia of Frankel B type was noted. Four cases recieved concervative treatment, while the other 4 recieved operative treatment. In 2 cases with extruded disc herniation at L1/2, discectomy followed by anterior interbody fusion was performed by the anterior approach, whereas a laminectomy and discectomy was performed by the posterior approach in 2 cases of sequenstrated disc herniation at L2/3. Pain disappeared in all 4 surgically treated cases, and in 2 cases of paralysis, partial neurological improvement was noted. A anterior or posterior approach should be carefully weighed before a surgical decision is made.
