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Extreme lateral disc herniation: diagnosis by computed tomographic scanning.
Neurosurgery
|May 1, 1984
Summary
Computed tomography (CT) scans accurately diagnose extreme lateral disc herniation, aiding surgical planning. This imaging technique is crucial for identifying nerve root compression, unlike traditional myelography.
Area of Science:
- Neurosurgery
- Radiology
- Spinal Imaging
Background:
- Extreme lateral disc herniation, compressing exiting nerve roots, is a recognized spinal condition.
- Historically, diagnosis was often delayed until surgical exploration.
Observation:
- This study reports on 12 cases of extreme lateral disc herniation.
- Computed tomography (CT) scans were used for preoperative diagnosis and localization.
- Myelography was performed in 9 cases, with 6 showing normal results and 3 abnormal, but with inaccurate localization.
Findings:
- CT scans correctly identified the location of nerve root compression in 11 of 12 cases.
- Myelography provided inaccurate localization in all 3 abnormal studies.
- Clinical presentations were non-specific, with a positive straight leg raise test in only 7 patients.
Implications:
- Preoperative CT imaging is essential for accurate diagnosis and surgical planning of extreme lateral disc herniation.
- CT scanning prevents unnecessary surgical exploration by precisely locating the herniation.
- This improves surgical outcomes by directing surgeons to the far lateral herniation site.