These are zombie versions of the vanilla UMA archetypes. It is also designed to be used with "dead is mostly dead" play styles. On death, this modlet will reset (not remove) skill points, and remove all books read. I also wrote a "manifesto" about the "dead is mostly dead" play style. It is inspired by player character deaths in State of Decay, though it's not possible to re-create that exactly in 7D2D. Upon death, the player is respawned in the same game world, with a "new" character (as opposed to "dead is dead" where the entire game world is lost or reset). It is designed to be used with "dead is mostly dead" play styles. New in version 2.0.0: Beds and bedrolls are once again craftable (they are now merely ornamental). Removes the ability of beds and bedrolls to act as spawn points, or protect against zombie spawns. They may be used with or without EAC enabled, and may be installed on any multiplayer server. They use XML and XPath, and do not require SDX/DMT or changes to any. These modlets do not have any dependencies on other mods or modlets. Please do, they are free as in "free beer" and as in "freedom." Credit is appreciated, but even that is not required - go nuts! Their small size also means they should be easy to modify, or to learn from, so that you can use them for your own purposes. You should be able to easily pick and choose which one(s) you want to use, without any extra "features" you don't want. Each modlet is meant to be something like a feature flag or game setting. There are quite a few modlets, and most are very small. This is because those files are updated with the modlet itself, so will contain up-to-date information. Instead of leaving detailed descriptions in this post, I will instead point you to the individual README files. The README files have many details about installation and usage, including whether it is recommended to create a new game world, as well as technical details about the creation of the modlet. These files can be read on the Web by going to the modlet's directory in the GitLab repo. Thanks to SphereII for including them in the Mod Launcher!ĭetailed installation instructions are in the Gitlab repo:Īdditionally, each modlet now has its own individual README file. They can be installed by putting their contents into the 7D2D Mods folder, or by installing them using the Mod Launcher. I'm releasing them to the public, and I hope you find them useful. I put together a few modlets for my own enjoyment.
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Enjoy A Wine Tasting Photo Credit: woahtams via Instagram Upon request, you may even be able to have your favorite label bottled during the tour. You will hear all of his funny stories about what it was like to grow on a winery with the Fussell family. You might even be lucky enough to get a tour lead by the owner of the winery, Jonathan Fussel. The well-versed staff will not only educate you, but also entertain you. During your tour, you are able to watch the bottling process and learn more in-depth about the history of the winery’s roots in Rose Hill, North Carolina. Take A Tour Photo Credit: duplinwinery via InstagramĬome in alone for a relaxing afternoon, or bring a group of friends to learn about Duplin’s winemaking method. Here is our extensive guide on everything you need to know regarding Duplin Winery. Although there is much more to do than just walk in for a tasting and leave with a bottle. They are most known for their Muscadine wine, often seen at local grocery stores. The winery is open Monday through Saturday and best of all, no reservations are required to join. The outdoor section has you overlooking a pond with games and fire pits all around. Just off of Hwy 17 S, near Barefoot Landing, Duplin Winery has a big, beautiful tasting room and gift shop. Its lower alcohol content of only 10 percent keeps things light.What is better than enjoying good wine, a great atmosphere, and wonderful company? At Duplin Winery, located in North Myrtle Beach, South Carolina, enjoy the outgoing atmosphere while sipping on sweet wine. Sweet Muscadine | Moscato lovers will swoon over this sweetheart with a fruity start and refreshing finish. With a mouthwatering taste of fruit complemented with crisp sweetness, this wine is great with any summer salad. Scuppernong | One of the first wines produced at Duplin is made from the white muscadine grape of the same name. At a lower 10.5 percent alcohol by volume, it’s easy to sip a second glass. It is velvety smooth with a clean crisp finish that will get you through those balmy August nights.īlack River Red | Made from a blend of North Carolina red muscadine and Catawba grapes from New York state, this wine is light in style with a fresh and lively finish. Hatteras Red | Duplin’s flagship wine is sweet, full bodied and nice to enjoy while entertaining alfresco on the patio with a slice of pizza.Ĭarolina Red | The sweetest selection from Duplin is made from the Coastal James variety of muscadine grape, picked late in the harvest. We picked our faves from Duplin’s 42 varietals that are perfect for a sweet summer sip. All Duplin wines are cold fermented to preserve the natural sweetness that only these grapes can produce. Skins of the muscadine grapes contain six to eight times the antioxidants as blueberries, and there is six times more resveratrol in muscadine grapes than in other red grapes.ĭuplin Winery is the largest producer of muscadine wines in the world, rolling out over 525,000 cases annually. Muscadine grapes contain higher levels of a particular antioxidant - resveratrol - than any other winemaking grape. Duplin Winery | Rose Hill, North Carolina | Myrtle Beach, South Carolina These sweet wines are made from the North Carolina-native muscadine grape that has surprising heart-health benefits despite its appeal to the sweet tooth. Since the game starts on boot up, I assume something like it us being used. Therefore, I can’t tell if an autorun.sys file was used. Neither MakeATR, ATR image explorer, nor Atari800MacX could read the image. The ATR does not seem to have a standard layout. Since he is selling the game, I can’t provide it to you without his consent. Hopefully, be willing to send you an image. How is the disk contstructed? Does it use an autorun.sys that starts the actual program? Could you move it to a normal sized disk image? I'm aware this isn't a great bug report, but since Tristam Island is being sold (albeit cheaply), I can't simply give you the ATR.īob it's hard for me to guess on what might be wrong without being able to run the image. I'm running macOS 10.15.7 on a late 2016 MacBook Pro with 16GB of memory (low end MacBook Pro so no Touch Bar). I've turned off all patches and the machine is set up as an NTSC XEGS. Since the interpreter is always reading the disk at each command, I'm assuming Atari800MacX is somehow getting confused by the disk. In both cases, the game doesn't crash when accessing that portion of the text adventure (z3) file. Unfortunately, the demo uses a standard ED disk size so the command doesn't crash the game in Atari800MacX. I tried the non-standard ATR in both Altirra (using Wine) and using real equipment (XEGS and Sdrive Max to load the ATR file). I see the disk stop at track 274 just before I see the error. I'm sure that's coming from the open source Infocom interpreter and won't help you debug the problem. When I use the purchased game ATR (non-standard size of 138K), the disk crashes with an interpreter error (Internal Error #8033) as soon as you give it the command "GO NE". It's a Infocom-style text adventure game. I have a bug report for version 5.4.3 (and probably before). Chomp down on some neon bits and outsmart other players in this Coolmath Games classic.Cool Math Games is a great way to stay cool and keep your mind active. Give your brain a workout!Play Powerline.io, an epic online multiplayer version of Snake. gabimfmoura tiktok Hundreds of free, online math games that teach multiplication, fractions, addition, problem solving and more. Coolmeth-games.xyz daily traffic: + 9 visitors and + 15 pageviews. Coolmeth-games.xyz is ranked 126.35% higher, + 434 122 positions. Very creative! I too look for ways to challenge our grand children with. VA Fluency 2: Students are introduced to Isotraps, Midpoint Isotraps, Super Symmetry Patterns, use of Harmonic Patterns Listing #8 or #9 in the Sirius software to see vibrations of … r nbatopshot Here's our set of cool math games, practice problem generators and free online flash cards for Arithmetic through AlgebraStudents gain facility putting meaning of planets and vibrations together to come up with a specific interpretation and using software to quickly access the needed information. 254k Followers, 80 Following, 948 Posts - See Instagram photos and videos from Coolmath Games In this video you will learn what is the last fish in tiny fishing cool math games.You can also check out this article about this topic. The following list of cool math games and activities for kids includes math video games, math board games, math puzzles and brain teasers, and other fun math game and. Using cool math games and activities in your lesson plans is a great strategy for boosting student engagement and excitement for learning math inside and outside of the classroom. 60.00.Stevens > 620 A Shotgun 16 Ga Barrel 28 Forend 7 Rd Mag Tube Adj Choke.Brief description, history, and disassembly of the early Stevens 520 12 gauge takedown. Savage Stevens Model 94 24 Trigger Guard New Free Shipping.Leather Gun Stock Cover Stevens Model 311 Butt Stock With Personalized With Name. See our huge selection of gun parts for sale today. 254k Followers, 80 Following, 948 Posts - See Instagram photos and videos from Coolmath Games wreg com weather Stevens Gun Parts for sale on eBay. There are many ways that children can learn math today. Unfortunately, it can be a painful process and not one that we enjoy. At some point in our lives, we all have to learn mathematics.These fun online games will help you brush up on your arithmetic skills quickly. 10 More Bullets.Cool Math Games are educational games featuring numbers, multiplication and subtraction. Play free online Fireboy and Watergirl unblocked at school or work. These games have no violence, no empty action, ju …. Coolmath Games is a brain training site, for everyone, where logic and thinking meets fun and games. In this video you will learn what is the last fish in tiny fishing cool math games.You can also check out this article about this topic: official account of the one and only Coolmath Games □ Fun, free logic & thinking games □ New Games added every week ️□□. Really clear math lessons (pre-algebra, algebra, precalculus), cool math games, online graphing calculators, geometry art, fractals, polyhedra, parents and teachers areas too. tvtropes madison Cool Math has free online cool math lessons, cool math games and fun math activities. If you have an account and haven't logged in yet, please login now. To access the features of this site, you must have a password-protected customer account. Now available on mobile are your favorite casual games and minigames from the web! Everyone may have fun playing the casual games, minigames, trivia, and brainteasers on Coolmath Games.ActiveNet Login. You can play Cool Math - Games like crazy games ABCya math games. Download Cool Math - CoolMath Games and enjoy it on your iPhone, iPad, and iPod touch. Cool Math has free online cool math lessons, cool math games and fun math activities. These consist of classic match-3 challenges, where you have to create matches of three or more tiles with the goal to destroy or collect certain elements from the field. All these things cost in-game currency (gold coins), which users can get by playing puzzle levels. Players are encouraged to start purchasing different species of fish, decorations, as well as comfort items for their new pets. In Fishdom, the main objective is to manage and grow a series of virtual aquariums. Available on multiple platforms including Windows, Mac OS X and Nintendo, the game eventually made its way to iOS and Android as well. So what happens if a year or two down the road you reinstall the game, do you get your purchased items back? I think you know the answer to that one.Since its original launch back in 2008, Playrix’s Fishdom has managed to remain one of the most popular match-3 games ever released. The problem is these payments are for single use items. In essence I have no problem with developers getting paid for their work. In the past the prompts would be for shareware titles, while this and most games now use in-app purchases. Well this is partly true, in that you could actually pay a decent amount of money up front for a good game and enjoy it without hassle. You may say, that games used to cost quite a bit to purchase outright and that you are just purchasing items in-app instead. You used to able to immerse yourself in games without constant prompts to pay real cash for DISPOSIBLE in-game items. I really wish game developers would stop this pay to play using in-app purchases. This developer does a great job at making a beautiful, fun game that you can choose to play for free or pay a few bucks for boosters.īottom-line - If you ignore the contstant in-app prompts to pay cash for items, you can actually advance in the game (not easily) and it is entertaining. There are extremes, when the ads and in-app purchases are overwhelming but this game is so far from that. I've never paid any money for this game and continue to find it entertaining and graphically beautiful.Īs a programmer myself, I get really annoyed with people who complain about ads and in-app purchases because a real person creates and maintains these games and they should be compensated in some way. There aren't any! I love that! There are options to pay money for boosters and help but even those are super descrete and are well hidden if you choose not to. The upside of this particular game to most other games is the lack of ads. It does get really challenging and exponentially more difficult which is kind of the point of a puzzle. Currently, I almost to level 3000 so there's lots of content to make your way through. This puzzle matching game is super fun and challenging. Questions? Contact our Tech Support by sending an email to or check our Web Support Portal: Please note! Fishdom is free to play, though some in-game items can also be purchased for real money. It's buddy-diving time: play with your Facebook friends!.Grab your scuba mask and enjoy amazing graphics.Liven up tanks with breath-taking underwater decor.Explore an exciting aquatic world with amusing 3D fish that each have their own personality.Play hundreds of challenging and fun match-3 levels.Unique gameplay: swap and match, design and decorate, play with and take care of fish-all in one place!.Hey, your finned friends are waiting for you-DIVE IN NOW! Feed them, play with them, and watch them interact with each other. Never Fishdomed before? Take a deep breath and dive into the underwater world of match-3 fun with Fishdom!Įngage in challenging and fun match-3 gameplay with unique twists as you decorate tanks to create cozy homes for lovely fish. Satellite remote sensing of additional air pollutants has been greatly expanded with the launch of the TROPOspheric Monitoring Instrument (TROPOMI) aboard the Sentinel-5 Precursor (S5P) satellite on 13 October 2017 ( Veefkind et al., 2012). The Orbiting Carbon Observatory-3 (OCO-3) aboard the International Space Station (ISS) since May 2019 ( Eldering et al., 2019) has provided additional observations of CO 2 in urban areas ( Kiel et al., 2021). Since the launch of the Orbiting Carbon Observatory-2 (OCO-2) in July 2014 ( Crisp et al., 2004), further studies have characterized emissions from urban regions (e.g., Wu et al., 2018 Reuter et al., 2019). ( 2012) used observations from the Greenhouse Gases Observing Satellite (GOSAT), launched in January 2009, to measure enhancements of atmospheric carbon dioxide ( CO 2) over megacities. The expansion of the constellation of Earth-observing satellites taking measurements of greenhouse gases and air pollutants has led to observations over urban regions with unprecedented spatiotemporal coverage. Atmospheric measurements have been shown to be useful as part of top-down approaches in validating and refining these emissions inventories ( McKain et al., 2012 Duren and Miller, 2012). These inventories are constructed using bottom-up approaches: information on socio-economic activity is used alongside expected emissions factors for these activities to model emissions ( Gurney et al., 2012 Janssens-Maenhout et al., 2019). Emissions inventories provide information about the distribution and sources of air pollution and greenhouse gas emissions as well as their trends over time. Improving air quality and reducing greenhouse gas emissions are focuses of environmental policy from global to municipal levels ( Gurney et al., 2018 a). Additionally, we use high-resolution CO 2 inventories for two cities (Los Angeles and Indianapolis) to estimate emissions of CO and NO 2 using our calculated enhancement ratios and find good agreement with both a previous modelling study for the megacity of Los Angeles and California Air Resources Board (CARB) inventory estimates. We further demonstrate that the calculation and intercomparison of enhancement ratios of multiple tracers can help to identify the underlying biases leading to disagreement between observations and inventories. We find that these global inventories underestimate CO emissions in many North American and European cities relative to our observed enhancement ratios, while smaller differences were found for NO 2 emissions. Enhancement ratios between species are calculated and compared to emissions ratios derived from four globally gridded anthropogenic emissions inventories. We apply this method to observations taken over or downwind of 27 large (population of >1 million) urban areas from around the world. Using co-located space-based measurements of carbon dioxide ( CO 2) from the Orbiting Carbon Observatory-2 and Orbiting Carbon Observatory-3 (OCO-2/3) and carbon monoxide ( CO) and nitrogen dioxide ( NO 2) from the TROPOspheric Monitoring Instrument (TROPOMI), we calculate total column enhancements for observations influenced by anthropogenic emissions from urban regions relative to clean background values. This article provides some excellent comparisons. Since most users test their rigs without a sense of scale for power and temperature, they can't compare apples to apples, especially when combined with major variables such as differences in ambient temperature, hardware configurations and software utilities. Otherwise, great work! I was very pleased to read this article!Ģ0741319 said:As the author of the Intel Temperature Guide - I can fully appreciate how much work went into creating this outstanding article, which has been sorely needed! The only utilities I've ever found that come as close as possible to 100% TDP are Prime95 v26.6 Small FFT's as a steady workload for thermal testing, and Asus RealBench as a fluctuating workload for stability testing.Īlthough the topic of Prime95 (with and without AVX) was covered, I would like to have seen RealBench included in your test suite,since it's widely accepted as an excellent utility for testing overall system stability, and uses a realistic AVX workload. However, since Intel validates their thermal specifications at a steady 100% TDP, it's most appropriate to select utilities that don't overload or underload the CPU. Nevertheless, our results are very similar. The Intel Temperature Guide differs in its approach toward the topic of processor Core temperatures and cooling with respect to Intel's TDP specifications, and distinguishes between steady workloads for thermal testing versus fluctuating workloads for stability testing. This article provides a perspective and some excellent comparisons. As the author of the Intel Temperature Guide - I can fully appreciate how much work went into creating this outstanding article, which has been sorely needed! Create a flowchart in word 2008 for mac 0 Comments You can also specify the intended or existing dependencies between layers. The Witcher 2: Assassins of Kings - Enhanced Edition added over 10GB of new. The Witcher 2 Assassins of Kings Enhanced Edition Mac OS 2021 Free Download. All new copies on PC and Xbox 360 shipped with the additional content on board. So, here are few additional reasons that may help some unsure fans pick a favorite. The Witcher 2 Assassins of Kings Enhanced Edition Mac OS GamePlay. Yet, it’s still so hard to decide between them. We’ve already given several reasons why each entry should be regarded as the better one. Even choosing between the two of them is tricky. In its defense, the second and third entries in The Witcher series are difficult to beat. Witcher available as a PC exclusive and The Witcher 2: Assassins of Kings never making it to PlayStation platforms. And while the exhilarating (albeit buggy) new cybernetic adventure is a solid title, it still struggles to match some of the developer’s previous efforts. The Witcher 2: Assassins of Kings is a gift, gilded with moments that stay with you even after the curtains close on its dark tale of uncertain pasts and uncertain futures. Updated February 11th, 2021 by Ben Jessey: With the recent release of Cyberpunk 2077, discussions regarding CD Projekt Red’s best game have started to intensify once again. To help determine which is the superior title, here is what each entry has over the other. One that introduced many fans to the series as it was the first to release on consoles. The Witcher 2: The Assassin of Kings doesn't have the same worldwide appeal as its successor, yet, it's a strong game in its own right. RELATED: The Witcher: The 10 Hardest Decisions You Have To Make In The Games (& What Comes Next) Thanks to the PC gaming and modding community, there is a strong selection of mods that help improve The Witcher 2 s experience to be more palatable in 2021. However, was it really that much better than its predecessor? The Witcher 2: Assassins of Kings was released over eight years ago on PC and Xbox 360 and shows its age today, but still released to a strong critical reception. Most of its fame can be attributed to the amazing Witcher 3, which earned several 'Game of the Year' awards in 2015. Welcome to CD PROJEKT RED Technical Support Here you will find help regarding our games and services, as well as answers to frequently asked questions. The items imported are not that much better than what you start with by default. The Enhanced Edition is a great bonus for PC players, but for Xbox 360 owners its good going into the game knowing that theres no outstanding DLC thatll cost. These days the Witcher series is one of the most popular in gaming. The Witcher 2: Assassins of Kings - Tips and Tricks for Getting Started If you have a Witcher 1 save then it imports some Orens (gold) and items, plus it may have minor dialogue influences. The latest builds are always available online on the software's download page and can be accessed as either a ZIP file or through the Bazaar repository using EclipseĪvailable for all major desktop operating systems: Windows, Linux and Mac OS Xįree online backup of complex user settings so hours of work are never lostįree add-on for integration with Microsoft Office WordĬons: Other similar software, such as Zotero and Mendeley, are suited for different things that might be better for the user's purposes. Pros: Completely free and open source, which means that anyone can fork and modify the code to their own needs. Docear also comes equipped with a unique document recommendation system that will automatically suggest new literature based upon what's already stored in the software's database, making additional research on a subject easier than ever. For example, within Docear, one can utilize reference management, PDF management and mind mapping without having to open more application on the machine. Thanks to the software's "literature suite" design, multiple tools are combined in a single application. What’s the difference between Docear and Scopus Compare Docear vs. Once a user gets the hang of Docear, it's possible to view multiple annotations of many documents at the same time. Bookvar is a mind mapping tool that allows you to rapidly create interactive and visually appealing multimedia mind maps, share ideas and collaborate via built-in chat service. Even the annotations on these documents can be sorted easily. Papers can be sorted into various categories with the click of a button. This comprehensive software features an easy-to-use single-part user interface for organizing any sort of scholarly research documents. Grouping nodes with visual containers (clouds) and accolade (summary node) Freeplane is a free, open source software application for creating mind maps (diagrams of connections between ideas), and electronic outlines.Classifying nodes with metadata (attributes) and style types (system styles, user-defined styles, level styles).Ordering ideas (nodes) into a hierarchy connected by lines (edges).Note-taking with freely positionable, unconnected nodes (post-it’s).It can be run locally or portably from removable storage like a USB drive.įreeplane TutorialFeatures and Highlights Runs on any operating system that has a current version of Java installed.Overall Opinion: While not many people have to deal with loads upon loads of academic research papers, those who are given the task are often faced with tedious organizational work. Written in Java, it is supported on Windows, Mac OS X and Linux, and is licensed under the GNU GPL version '2 or later'. Connecting nodes with dynamic links, free lines (connectors) and labels.Automatically styling nodes (with a bubble, color, edge type, etc.) according to hierarchical level and content (conditional styles, automatic edge color, level styles).Structuring nodes in terms of content (text, scientific formula, calculation, icon, image and hyperlink) and presentation area (core, details, notes, attributes, images, and tooltip).Changing views by hiding content (folding branches, filtering, roll-up of details and hiding extensions in a tooltip), finding, scrolling and navigating.Password protecting of whole map and of individual nodes with DES encryption.Support for LaTeX formulae underneath/in nodes Freeplane is free, Open-Source software to support thinking, sharing information, and getting things done at work, in school, and at home.Approximate Search (similarity search) which allows to find search terms in a text, even if there is no exact match (e.g.Ease of use with inline- and dialog editors, object-oriented main menu, context menu’s, multi-language support, spell checker, properties panel, drag& drop functionality, hot keys, options for batch execution, publishing, sharing and selectable preferences. The core of the software consists of functions for mind mapping, also called concept mapping or information mapping, and tools for using mapped information. Freeplane is a powerful and free mind mapping application. Freeplane runs on any operating system on which a. It is a redesigned version of the well known FreeMind, and is created by one of FreeMind's key developers. Extensive support through Wiki and Forum and tutorial and documentation in the form of a mind map.įreeplane for macOS runs on any operating system that has a current version of Java installed.Integration with Docear academic literature suite.Easy extension of functionality with add-ons and homemade scripts.The software is written in Java, and supports any platform capable of running current versions of Java, including: Microsoft Windows. Docear is based on the mind mapping software Freeplane and all add-ons for Freeplane should work with Docear. It can be run locally or portably from removable storage like a USB drive. Motor and sensory examinations were graded by the operating surgeon as improved, unchanged, or worse. Patients' outcomes were assessed using a modified Odom's criteria. Radiographs included standing anteroposterior, lateral lumbar views, and dynamic flexion/extension radiographs for determination of the stability status. In addition to radiographic analysis, postoperative follow-up evaluation included a review of medical records and a postoperative visit to the outpatient clinic. They were then followed up at 1, 3, 6, and 12 months postoperatively, and then annually. Patients underwent postoperative radiograph prior to discharge. B : Photographs after ventral durotomy showing the disc removal by pituitary forceps through the dural hole. A : Photograph after laminectomy and dural opening demonstrating central bulging of the ventral dura. Adequate decompression with removal of calcified disc fragments and osteophytes was accomplished after meticulous dissection of dense adhesions between the disc herniation and the dural sac. An intentional durotomy, over its maximal bulging of the ventral dura, was performed ( Fig. After laminectomy, the incised dorsal dura was tacked, and the cauda equina rootlets were gently retracted. If dural sac or root retraction was not possible due to a large-sized central disc herniation, a transdural approach was selected to reduce the risk of nerve root injury ( Fig. Bilateral laminectomy was chosen if the patient complained of bilateral radiating pain. After retracting the compressed dural sac and discectomy, the nerve root was decompressed positively. Unilateral hemilaminectomy in symptomatic lesions and medial resection of the zygoapophyseal joints were performed in order to gain sufficient exposure of the discs. The accurate level of herniated disc was checked by intraoperative fluoroscopy. Under general anesthesia, the patient is usually prone positioned on an operating frame. Three surgical methods that included unilateral laminectomy, bilateral laminectomy, and a transdural approach were used. Disc consistency, direction, and size were also investigated on T2WI of MRI.Īll patients underwent a discectomy via a posterior approach. On preoperative magnetic resonance (MR) imaging or computerized tomography (CT) scan, we measured the area of the spinal canal and protruded disc material at the compressive level. Accurate distribution of sensory change was also evaluated. Preoperative data collected during review of patient medical records included the presence or absence of lower back and radicular pain, motor or sensory deficit, reflex changes, and sphincter dysfunction. Patients with the following conditions were excluded : obvious spondylosis or ossification of the ligamentum flavum or far lateral disc herniation. We retrospectively reviewed the medical records, radiological examinations and operative findings of 41 patients with symptomatic L1-L2 and L2-元 disc herniation who underwent surgery in our institute between January 1998 and December 2007. In this article, through retrospective review of our patients' data, we investigated the clinical features and surgical outcomes of upper lumbar disc herniations, and evaluated the predictive factors for determination of surgical methods. Because of this unique anatomy, selection of a surgical approach is difficult. Lengths of the lamina are shorter, location of pain varies, and direct cord compression may occur. Spinal canals are narrower than those of lower levels, which may compromise multiple spinal nerve roots or conus medullaris. Incidence of herniated upper lumbar discs defined as only L1-L2 and L2-元 are known to comprise approximately 1 to 2% of all herniated lumbar discs 5, 10).Ĭompared with those of lower levels, upper lumbar disc herniations have a less favorable outcome after surgery 16). Therefore, the 元-L4 level might be excluded from the upper lumbar disc. However, the anatomical characteristics of 元-L4 discs are more similar to lower levels, and its surgical outcome is significantly different from that of L1-L2 and L2-元 13, 17). Among these reported cases, herniations at the 元-L4 level comprise 70-83% of all upper lumbar disc herniations 2, 15, 19). Upper lumbar disc herniations have been reported to occur with a frequency of less than 5% of all disc herniations 2, 17). Most previous studies of upper lumbar disc herniations included the L1-L2, L2-元, and 元-L4 levels. Upper lumbar discs have been reported as only L1-L2 and L2-元 by some authors, and by others as T12-L1, L1-L2, and L2-元 3, 5, 8). Use of the term "upper lumbar" disc has been controversy. Compared to the lower one, upper lumbar spine results in fewer cases of spondylosis, disc generation, and fewer herniated discs. Due to the unique anatomy of the upper lumbar spine, upper lumbar disc herniations are different from those that occur at lower levels of the lumbar spine. |