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[Lateral lumbar disk hernia].

A Monod1, P Desmoineaux, A Deburge

  • 1Service de Chirurgie Orthopédique et Traumatologique, Hôpital Beaujon, Clichy.

Revue De Chirurgie Orthopedique Et Reparatrice De L'Appareil Moteur
|January 1, 1990
PubMed
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Lateral lumbar disc herniations (L.D.H.) are rare, often presenting with specific symptoms like cruralgia. CT scans are the preferred diagnostic tool, with chemonucleolysis and surgery showing good outcomes.

Area of Science:

  • Neurosurgery
  • Radiology
  • Orthopedics

Background:

  • Lateral lumbar disc herniations (L.D.H.) occur within the foramen, compressing nerve roots.
  • Understanding L.D.H. requires evaluating clinical, radiographical, and therapeutic aspects.

Purpose of the Study:

  • To analyze the clinical presentation, diagnostic methods, and treatment outcomes of lateral lumbar disc herniations.
  • To determine the frequency and optimal management strategies for L.D.H.

Main Methods:

  • Retrospective review of 23 L.D.H. cases from 590 discal herniation patients (1984-1987).
  • Evaluation of clinical signs, saccoradiculography, discography, T.D.M. (CT), and disco-CT.
  • Analysis of treatment outcomes for chemonucleolysis and surgical interventions.

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Main Results:

  • L.D.H. frequency was 3.8% in the studied series.
  • Suggestive clinical signs include cruralgia and a rarely positive Lasegue's test.
  • CT scans were the investigation of choice; disco-CT aided in evaluating sequestration.
  • Chemonucleolysis had 9/14 successful outcomes; failures were linked to osseous stenosis.
  • 9 patients treated surgically had good results.

Conclusions:

  • L.D.H. diagnosis relies on specific clinical indicators and advanced imaging like CT.
  • Chemonucleolysis is effective when indicated, but surgical intervention offers good outcomes.
  • Proper patient selection is crucial for successful chemonucleolysis in L.D.H.