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Herniation of the Disc between the First and Second Lumbar Vertebrae with a Monoradiculopathy of the Fifth Lumbar Nerve Root. A Case Report*
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Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo
J Bone Joint Surg Am, 1996 Sep 01;78(9):1422-6
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The clinical presentation of a herniated lumbar disc depends on which nerve root is affected. Therefore, the diagnosis of the level of herniation is initially based on the neurological symptoms and signs and is confirmed by a radiographic examination. Herniation of a disc at a level between the first and fourth lumbar vertebrae usually causes compression of the second, third, or fourth lumbar nerve roots. In addition, the herniation is associated with characteristic findings, including pain and sensory loss over the anterior portion of the thigh or the medial aspect of the leg, or both; a positive femoral-nerve-stretch test; weakness of the quadriceps or the iliopsoas muscle, or both; and a diminished or absent patellar ligament reflex3. Our report describes a patient who had a herniated disc between the first and second lumbar vertebrae with sciatica and a monoradiculopathy of the fifth lumbar nerve root.
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