Cervical spine injury is a commonly encountered entity in most neurosurgical practice and is increasing with social environment. Universally accepted treatment modality for acute cervical spine injuries do not exist and several areas of controversy surround the issue of surgical intervention in the management of trauma to the cervical spine.

A retrospective study of 86 injured cervical spine patients who admitted and carried out a surgical treatment at Dong Dae Moon Hospital between Sep.92 and Aug.96 for the past four-year-period.

The author analyzed 86 patients with traumatic cervical spine injuries for the past 4 years. The incidence was highest in middle aged men(ratio : 6.8) and the traffic accident was the most common exclusive cause(68%). In 9 cases of C1-2 spine injury, they underwent posterior approach. In 74 cases of mid-lower(C3-7) cervical injury, the anterior approach was used in 57 patients, the posterior approach was used in 13 patients and the combined approach was used in 4 patients. The surgical complication rate was 15%(13 cases).

Internal fixation with variety of devices has become a popular procedure for cervical spine injuries.

In this study, the rate of re-operation and complications following initial surgical procedures were found to be higher than previous report of other authors. It could be concluded that choosing the most proper surgical approach for cervical spine injuries with minimal risks and adhering to stringent criteria are much important than simply selecting new fancy devices over the traditional one.

Lumbar disc herniations at the L1-L2, L2-L3, and L3-L4 level are rare. The purpose of this study is to observe the variable clinical finding of upper lumbar disc herniations and to provide proper treatment modality.

Between 1998 Jan. and 1999 Dec., seventeen patients with upper lumbar disc herniations who were undergone surgery in our institute were retrospectively evaluated. Patients were evaluated based on following factors : age, sex, aggravating factor, symptoms and signs type of disc herniation, type of surgery, and outcome of post-surgery.

The incidence of lumbar disc herniation at the level of L1-2, L2-3 and L3-4 is 6.1% with declining frequency as the level ascends. The peak age incidence is 6th decade in both sex. Preoperative symptomes and signs are variabe. In sixteen cases, posterior approach was done. In these cases, twelve cases were performed microscopic partial hemilaminectomy, and four cases with spinal stenosis were performed total laminectomy and posterior screw fixation with bone fusion. In one case, lateral extracavitary approach was done. In results of operation, fourteen cases showed more than good grade(82%).

The age incidence of lumbar disc herniations at the level of L1-2, L2-3 and L3-4 older than lumbar disc herniations at the lower level of L4-5 and L5-S1. The signs and symptoms are variable. In our cases, most of the patients were performed posterior approach with microscopic partial hemilaminectomy except the patients combined spinal stenosis. One case was performed a lateral extracavitary approach because the risk of the cord and cauda equina injuries. The prognosis of upper lumbar disc herniations after treatment with only microscopic partial hemilaminectomy and diskectomy is comparable with the prognosis of lumbar disc herniations at the lower level.