Huge Intracanal lumbar Disc Herniation: a Review of Four Cases
Lumbar disc herniation (LDH) is the most common cause of sciatica and only in about 10% of the affected patients, surgical intervention is necessary. The side of the patient (the side of most prominent clinical complaints) is usually consistent with the side of imaging (the side with most prominent disc herniation on imaging scans). In this case series, we presented our experience in four cases with huge intracanal LDH that a mismatch between the patient’s side and the imaging’s side was present. In these cases, for deciding to do the operation, the physicians need to rely more on clinical findings, but for deciding the side of discectomy, imaging characteristic (imaging side) may be a more important criterion.
Frymoyer JW. Back pain and sciatica. N Engl J Med 1988;318(5):291-300.
Boden SD, Davis DO, Dina TS, et al. Abnormal magneticresonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990;72(3):403-8.
van Rijn JC, Klemetso N, Reitsma JB, et al. Symptomatic and asymptomatic abnormalities in patients with lumbosacral radicular syndrome: Clinical examination compared with MRI. Clin Neurol Neurosurg 2006;108(6):553-7.
Danon-Hersch N, Samartzis D, Wietlisbach V, et al. Appropriateness Criteria for Surgery Improve Clinical Outcomes in Patients With Low Back Pain and/or Sciatica. Spine 2010;35(6):672-83.
Pearson A, Lurie J, Tosteson T, et al. Who should have surgery for an intervertebral disc herniation? Comparative effectiveness evidence from the spine patient outcomes research trial. Spine 2012;37(2):140-9.
Akdeniz T, Kaner T, Tutkan I, et al. Unilateral surgical approach for lumbar disc herniation with contralateral symptoms. J Neurosurg Spine 2012;17(2):124-7.
Sucu HK, Gelal F, Lumbar disk herniation with contralateral symptoms. Eur Spine J 2006;15(5):570-4.
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