Biomaterial Database

Extreme lateral disc herniation: diagnosis by computed tomographic scanning. 1984

J C Godersky, and D L Erickson, and E L Seljeskog

Extreme lateral disc herniation with compression of the nerve root as it exits through the foramen has been a recognized entity for a number of years. Until recently, this diagnosis was made infrequently except at the time of operation. Reported here are 12 cases of root compression from disc herniation at the level of the pedicle or farther laterally in the foramen (extreme lateral disc herniation). Diagnosis and localization of the root compression were determined preoperatively in 11 of 12 cases based on the computed tomographic (CT) scan appearance of the lesion. Myelography was performed in 9 cases and was interpreted as normal in 6 and abnormal in 3 instances. In each of the 3 abnormal studies, the actual abnormality was at a different level than that predicted by the myelogram. The clinical presentations in these patients were not distinct except that a positive straight leg raising test was present in only 7 of 12. Preoperative knowledge of the site of nerve root compression as delineated by CT scanning was essential in planning the operative procedure. It prevented unnecessary exploration of uninvolved levels and directed the surgeon to the far lateral site of the herniation. Illustrative examples are presented.

UI	MeSH Term	Description	Entries
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
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
D009408	Nerve Compression Syndromes	Mechanical compression of nerves or nerve roots from internal or external causes. These may result in a conduction block to nerve impulses (due to MYELIN SHEATH dysfunction) or axonal loss. The nerve and nerve sheath injuries may be caused by ISCHEMIA; INFLAMMATION; or a direct mechanical effect.	Entrapment Neuropathies,Nerve Entrapments,External Nerve Compression Syndromes,Internal Nerve Compression Syndromes,Nerve Compression Syndromes, External,Nerve Compression Syndromes, Internal,Compression Syndrome, Nerve,Compression Syndromes, Nerve,Entrapment, Nerve,Entrapments, Nerve,Nerve Compression Syndrome,Nerve Entrapment,Neuropathies, Entrapment,Neuropathy, Entrapment,Syndrome, Nerve Compression,Syndromes, Nerve Compression
D003937	Diagnosis, Differential	Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures.	Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004576	Electromyography	Recording of the changes in electric potential of muscle by means of surface or needle electrodes.	Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man