Document Detail


Extraforaminal lumbar disk herniation. Clinical features and computerized tomography.
MedLine Citation:
PMID:  1783549     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Disk herniation lateral to the intervertebral foramen is defined as extraforaminal. Its particular anatomical site makes its clinical and neurologic features completely different from those of posteromedial and posterolateral disk herniations. Prior to the advent of computerized tomography, only diskography was capable of preoperatively identifying this rare disease. We present 5 cases of extraforaminal disk herniation, the clinical and tomographic diagnosis of which was confirmed at surgery. All patients had severe motor deficit and reported sciatica as prevalent over low back pain. The herniated disk was L4-5 in 2 cases and L5-S1 in 3 cases. The CT scan suggested disk protrusion in 2 cases, extrusion in 2 cases, and sequestration in 1 case. Four of these findings were confirmed intraoperatively. Diskectomy was done after hemilaminectomy and partial or total facetectomy. The clinical result was excellent in 2 cases and good in 3 cases after an average follow-up of 10 months. The use of CT scan as part of the routine diagnostic procedure in patients with radicular pain has lowered the number of cases which the surgical findings were inexplicably negative for disk herniation without having to resort to more complex and invasive diagnostic techniques such as myelo-CT and disk-CT. Moreover, preliminary tomographic localization of the extraforaminal disk herniation makes it possible to operate on the affected level using more conservative techniques. In any case, thorough clinical examination is essential for both correct interpretation of the CT scan and appropriate choice of treatment.
Authors:
A Santini; R P Pitto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Italian journal of orthopaedics and traumatology     Volume:  17     ISSN:  0390-5489     ISO Abbreviation:  Ital J Orthop Traumatol     Publication Date:  1991 Sep 
Date Detail:
Created Date:  1992-03-19     Completed Date:  1992-03-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7511480     Medline TA:  Ital J Orthop Traumatol     Country:  AUSTRIA    
Other Details:
Languages:  eng     Pagination:  359-69     Citation Subset:  IM    
Affiliation:
Divisione di Ortopedia e Traumatologia, Ospedale Civile, Arezzo.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Follow-Up Studies
Humans
Intervertebral Disk / surgery
Intervertebral Disk Displacement / diagnosis*,  radiography,  surgery
Laminectomy
Lumbar Vertebrae / radiography*,  surgery
Male
Middle Aged
Myelography
Tomography, X-Ray Computed

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