Surgical outcomes of upper lumbar disc herniations (ULDHs) including T12-L1, L1-L2, and L2-L3 levels are characteristically less favorable and more unpredictable. This study was conducted to compare the surgical outcomes of decompression alone versus decompression combined with transpedicular screw fixation in treating upper lumbar disc herniation. This retrospective cohort study was carried out at Neurosurgery Departments, Tanta University. The study included 46 patients with a symptomatic high lumbar herniated disc at T12-L1, L1-L2, and L2-L3 levels. The enrolled patients were divided into two groups depending on whether they were operated on via decompression and partial medial facetectomy (group 1, 22 patients) or via the previous maneuver plus transpedicular screw fixation (group 2, 24 patients). All patients were medically evaluated immediately after the operation; then, they were followed up at the 3rd and the 6th months following surgery. Patients’ outcomes were assessed by visual analogue score (VAS) and Oswestry Disability Index (ODI) scores. Median VAS scores in each group revealed significant reduction immediately following surgery and at each of 7 days, 3 months, and 6 months in comparison with the preoperative VAS score (p<0.001). Furthermore, each group showed significant stepwise reduction in the median ODI score at the 3rd and the 6th months postoperative compared to the preoperative ODI score (group 1 = 68.0, 19.0, 15.0; p< 0.001 and group 2 = 66.5, 20.0, 15.0; p< 0.001), with no significant differences between both groups (p> 0.05). Both standalone decompression and decompression combined with transpedicular screw fixation revealed comparable favorable outcomes in patients with ULDH.

中文翻译：

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单纯减压与经椎弓根螺钉固定治疗上腰椎间盘突出症的手术结果

包括 T12-L1、L1-L2 和 L2-L3 水平在内的上腰椎间盘突出症 (ULDH) 的手术结果通常不太有利且更难以预测。本研究旨在比较单独减压与减压联合经椎弓根螺钉内固定治疗上腰椎间盘突出症的手术效果。这项回顾性队列研究是在坦塔大学神经外科系进行的。该研究包括 46 名 T12-L1、L1-L2 和 L2-L3 水平有症状的高位腰椎间盘突出症患者。根据他们是通过减压和部分内侧关节突切除术（第 1 组，22 名患者）还是通过先前的操作加经椎弓根螺钉固定术（第 2 组，24 名患者），将纳入的患者分为两组。所有患者在手术后立即进行医学评估；然后，他们在手术后的第 3 个月和第 6 个月进行了随访。通过视觉模拟评分 (VAS) 和 Oswestry 残疾指数 (ODI) 评分评估患者的结果。与术前 VAS 评分相比，每组的中值 VAS 评分在手术后即刻和第 7 天、3 个月和 6 个月时均显着降低（p<0.001）。此外，与术前 ODI 评分相比，各组在术后第 3 个月和第 6 个月的 ODI 评分中位数显着降低（第 1 组 = 68.0、19.0、15.0；p < 0.001；第 2 组 = 66.5、20.0、15.0； p < 0.001），两组之间没有显着差异（p> 0.05）。