Extraforaminal lumbar disk herniation. Clinical features and computerized tomography. 1991

A Santini, and R P Pitto
Divisione di Ortopedia e Traumatologia, Ospedale Civile, Arezzo.

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.

UI MeSH Term Description Entries
D007403 Intervertebral Disc Any of the 23 plates of fibrocartilage found between the bodies of adjacent VERTEBRAE. Disk, Intervertebral,Intervertebral Disk,Disc, Intervertebral,Discs, Intervertebral,Disks, Intervertebral,Intervertebral Discs,Intervertebral Disks
D007405 Intervertebral Disc Displacement An INTERVERTEBRAL DISC in which the NUCLEUS PULPOSUS has protruded through surrounding ANNULUS FIBROSUS. This occurs most frequently in the lower lumbar region. Disc Herniation,Disc Protrusion,Disc, Herniated,Disk Herniation,Disk Protrusion,Disk, Herniated,Intervertebral Disc Herniation,Intervertebral Disc Protrusion,Intervertebral Disk Displacement,Intervertebral Disk Herniation,Intervertebral Disk Protrusion,Prolapsed Disk,Protruded Disc,Protruded Disk,Slipped Disk,Disk Prolapse,Herniated Disc,Herniated Disk,Prolapsed Disc,Slipped Disc,Disc Displacement, Intervertebral,Disc Herniations,Disc Protrusion, Intervertebral,Disc Protrusions,Disc Protrusions, Intervertebral,Disc, Prolapsed,Disc, Protruded,Disc, Slipped,Discs, Protruded,Disk Displacement, Intervertebral,Disk Herniations,Disk Prolapses,Disk Protrusion, Intervertebral,Disk Protrusions,Disk, Prolapsed,Disk, Protruded,Disk, Slipped,Herniated Discs,Herniated Disks,Herniation, Disc,Herniation, Disk,Herniation, Intervertebral Disc,Herniation, Intervertebral Disk,Intervertebral Disc Displacements,Intervertebral Disc Herniations,Intervertebral Disc Protrusions,Intervertebral Disk Displacements,Intervertebral Disk Herniations,Intervertebral Disk Protrusions,Prolapse, Disk,Prolapsed Discs,Prolapsed Disks,Prolapses, Disk,Protruded Discs,Protruded Disks,Protrusion, Disc,Protrusion, Disk,Protrusion, Intervertebral Disc,Protrusion, Intervertebral Disk,Protrusions, Intervertebral Disk,Slipped Discs,Slipped Disks
D007796 Laminectomy A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots. Laminotomy,Laminectomies,Laminotomies
D008159 Lumbar Vertebrae VERTEBRAE in the region of the lower BACK below the THORACIC VERTEBRAE and above the SACRAL VERTEBRAE. Vertebrae, Lumbar
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009192 Myelography X-ray visualization of the spinal cord following injection of contrast medium into the spinal arachnoid space. Cisternography, Myelographic,Myelographic Cisternography,Cisternographies, Myelographic,Myelographic Cisternographies,Myelographies
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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