Diagnosis of foraminal and extraforaminal lumbar disk herniation

Thanks to the more systematical use of CT scan, more and more foraminal and extraforaminal disk herniations are discovered. Some symptoms and signs can be suggestive. Association of negative myelography with important radicular signs should receive special attention. The extremely lateral herniation can be managed easiest and safest by a combined approach, both interlaminar paramedian and lateral to the facet joint, which should be preserved.