Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1387
5
1
gregorian
2008
8
1
22
2
online
1
fulltext
en
Intraforaminal and extraforaminal far lateral lumbar disc herniation ( a review of 63 cases)
Neurosurgery
Neurosurgery
Original Research
Original Research
<p> <strong> Abstract </strong></p><p> <strong> Background: </strong>Far lateral discal herniation is an uncommon disorder and is difficult </p><p> to assess by physical examination alone. This study is designed to define clinical and </p><p> epidemiological findings and to establish the indications of surgical and medical treatment for FLLDH. </p><p> <strong> Methods: </strong>Between 2000 and 2005, a total of 2035 patients with lumbar disc herniation </p><p> underwent surgical discectomy by the authors in several neurosurgical centers </p><p> in Mashhad. Among these patients, 63 (3.1%) had FLLDH (42 men and 21 women). </p><p> Clinically these patients had unilateral radicular pain with or without paresis. SLR </p><p> was positive in 100% of cases. Conservative therapy consisting of bed rest, nonsteroidal </p><p> anti-inflammatory drugs and physiotherapy had failed. We used a combination </p><p> of classical interlaminar approach and the intertransverse route through a midline approach for the treatment of our patients. </p><p> Results: From 63 cases in our series, 42 were men and 21 were women. 19 patients </p><p> had extraforaminal and 44 had foraminal disc herniation. The most common level for </p><p> far lateral discal herniation was L4-L5. Our patients had LBP in 43.6% (27 cases) and </p><p> positive SLR and radicular leg pain in 100% (63 cases). In all patients leg pain was relieved immediately after surgery. </p><p> <strong> Conclusion: </strong>FLLDH should be considered in all cases with lower limb radiculopathy. </p><p> These patients have more severe radicular pain than patients with paracentral </p><p> lumbar disc herniation. FLLDH happens more frequently at L4-L5 and L3-L4 levels. </p><p> It can often be difficult to diagnose or easily overlooked on radiographic studies. In </p><p> almost all cases, conservative treatment is unsuccessful and surgical treatment is recommended. </p>
far lateral disc, lumbar spine, foraminal and extraforaminal, disc surgery
63
67
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-44&slc_lang=en&sid=1
Fariborz
Samini
SAMINIF@MUMS.ac.ir
20031947532846001589
20031947532846001589
Yes
Department of Neurosurgery, Ghaem Medical Center,Mashhad, Iran
Gholamreza
Bahadorkhan
20031947532846001590
20031947532846001590
No
Mashhad Medical University, Mashhad, Iran.
Mohammad Reza
Ehsaei
20031947532846001591
20031947532846001591
No
Mashhad Medical University, Mashhad, Iran.
Hamed
Kheradmand
20031947532846001592
20031947532846001592
No
Mashhad Medical University, Mashhad, Iran.