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Extreme lateral lumbar disc herniation.

H Fankhauser1, N de Tribolet

  • 1Department of Neurosurgery, Center Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

British Journal of Neurosurgery
|January 1, 1987
PubMed
Summary
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Extreme lateral lumbar disc herniation (ELLDH) is a rare condition, found in 6% of lumbar disc surgeries. Diagnosis relies on CT scans, with surgical approaches varying based on herniation location.

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Extreme lateral lumbar disc herniation (ELLDH) involves disc material extending beyond the intervertebral foramen.
  • This condition represents 6% of all lumbar disc herniation surgeries.

Purpose of the Study:

  • To analyze the incidence, clinical presentation, diagnostic methods, and surgical approaches for ELLDH.
  • To detail specific surgical techniques for accessing and treating ELLDH.

Main Methods:

  • Retrospective analysis of 95 ELLDH cases from 1600 lumbar disc operations.
  • Review of diagnostic imaging (CT, myelography) and surgical procedures (facetectomy, lateral approaches).

Main Results:

  • ELLDH most commonly occurred at L5-S1 (43%) and L4-5 (38%).

Related Experiment Videos

  • Clinical presentation varied by level but mimicked paramedian herniations.
  • CT scans were highly effective for diagnosis; myelography showed nerve root sheath abnormalities.

    • Conclusions:

    • ELLDH is an uncommon but significant cause of lumbar disc pathology.
    • Accurate diagnosis is achievable with CT, and tailored surgical approaches are crucial for successful treatment.