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Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
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Lumbar Disc Herniation Presented with Contralateral Symptoms.

Pius Kim1, Chang Il Ju1, Hyeun Sung Kim2

  • 1Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea.

Journal of Korean Neurosurgical Society
|March 8, 2017
PubMed
Summary
This summary is machine-generated.

Contralateral neurologic deficits in lumbar disc herniation (LDH) may stem from traction forces and lateral recess stenosis, not direct compression. Surgical intervention for LDH effectively resolved these symptoms.

Keywords:
ContralateralHerniated diskLumbar

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Neurology

Background:

  • Lumbar disc herniation (LDH) can present with neurologic deficits on the side opposite the herniation.
  • The exact mechanism causing these contralateral deficits remains unclear.
  • Understanding the underlying pathology is crucial for effective treatment.

Purpose of the Study:

  • To investigate the mechanism behind contralateral neurologic deficits in patients with LDH.
  • To identify the optimal surgical treatment for these specific cases.
  • To analyze radiological and electrophysiological findings associated with this condition.

Main Methods:

  • Retrospective review of 8 patients with LDH and contralateral neurologic deficits (Jan 2009 - June 2015).
  • Analysis of magnetic resonance imaging (MRI) and electromyography (EMG) findings.
  • Surgical treatment involved decompression on the symptomatic side, with or without contralateral decompression.

Main Results:

  • MRI showed laterally skewed paramedian disc herniations, suggesting a traction mechanism.
  • EMG indicated radiculopathies in either one or both sides.
  • Surgical decompression led to significant resolution of symptoms.

Conclusions:

  • Contralateral neurologic deficits in LDH are likely caused by traction forces and lateral recess stenosis.
  • Direct nerve root compression is less probable as the primary cause.
  • Surgical treatment targeting these mechanisms offers effective symptom relief.