Surgical management of extreme lateral lumbar disc herniations: review of 138 cases
| Autor: | Wolber Pg, Gunadi Ik, Warfield, Abdullah Af |
|---|---|
| Rok vydání: | 1988 |
| Předmět: |
Adult
Male medicine.medical_specialty Facet (geometry) medicine.medical_treatment Discography Computed tomography Lumbar medicine Humans Aged Aged 80 and over Lumbar Vertebrae medicine.diagnostic_test business.industry Intervertebral Disc Chemolysis Intervertebral disc Microsurgery Middle Aged Surgery medicine.anatomical_structure Female Neurology (clinical) business Tomography X-Ray Computed Myelography Intervertebral Disc Displacement |
| Zdroj: | Neurosurgery. 22(4) |
| ISSN: | 0148-396X |
| Popis: | Extreme lateral disc herniations in the authors' series account for 10% of all lumbar herniations; 80% occurred at the L3, L4 and L4, L5 interspaces. The authors review the clinical findings in 138 patients and point to the characteristic features of the clinical syndrome. They compare the accuracy of various diagnostic studies and conclude that computed tomography is highly accurate and should be used before other diagnostic studies. Discography is still helpful as a confirmatory study in some cases, whereas myelography is particularly useful in disclosing other associated lesions. Analysis of the operative series revealed a high percentage of extruded fragments (60%) and a significant number of double herniations on the same side and at the same level (15%). These two findings may respectively preclude chemonucleolysis and microsurgery from the surgical management of extreme lateral herniations. Double herniations explain some discrepancies in the clinical picture and are emphasized as a potential source of error in diagnosis. The surgical technique allows exploration for herniations within the intervertebral canal as well as for extraforaminal herniations without sacrifice of the facet. Operative results are presented. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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