[Use of modified lateral nucleus pulposus herniation classification in low back pain]

Nucleus pulposus herniation is one of frequent causes in spinal pains. The necessity of undertaking of appropriate treatment, often surgical, requires early establishing of precise diagnosis. The traditional classification of herniations into central, centrolateral and lateral seems to be insufficiently precise, especially from the surgical point of view. For that purpose, the authors, following the classification of Volle et al., applied in their analysis the new classification into central and lateral nucleus pulposus herniae and discerning among the latter ones four types with strictly defined localisation: mediolateral, lateral with recess involvement, intervertebral foramen hernia, outside intervertebral foramen hernia. Seventy-two cases were analysed. Hernia was diagnosed by means of CT. Particular attention was given to the most external hernias, that is into and outside the intervertebral foramen. The more accurate method for the assessment of hernias and bone changes was in CT the Reconstruction in sagittal and frontal planes and also in oblique projections. The authors believe that the diagnosis of lateral nucleus pulposus hernias in low spinal area, particularly those with herniation into and outside the intervertebral foramen should be based on CT in appropriate reconstructions.