[Foraminal lumbar hernia. Diagnostic and therapeutic aspects (apropos of 40 cases)]

This study was based upon a retrospective analysis of 40 case-histories of foraminal lombar disc herniations. Patients presented an isolated femoral neuralgia 3 times out of 4, were males twice out of 3 and were about fifty. Computed Tomographic Scanning oriented precisely the diagnosis for half the cases but only suggested it for the other 50 per cent. Computed Tomographic Scanning of lumbar discography was executed 5 times and confirmed the foraminal lumbar disc herniation. MRI executed 18 times confirmed the foraminal lumbar disc herniation by sagittal, axial and frontal-oblique views. 7 patients recovered with medical treatment. 4 patients with a subligamentous lumbar disc herniation recovered with percutaneous treatment. 29 patients underwent surgical treatment. The classical intervertebral foramina approach by complete facetectomy and arthrodesis was replaced by more conservative technics regarding bony structures: extraforaminal lumbar disc herniation was removed by paraspinal approach, whereas foraminal lumbar disc herniation was removed by a combined approach associating an interlaminar approach with a paraspinal one.