Lumbar disk herniation with contralateral symptoms.
The aim of the study is to determine if leg pain can be caused by contralateral lumbar disk herniation and if intervention from only the herniation side would suffice in these patients. Five patients who had lumbar disk herniations with predominantly contralateral symptoms were operated from the side of disk herniation without exploring or decompressing the symptomatic side. Patients were evaluated pre- and postoperatively. To our knowledge, this is the first reported series of such patients who were operated only from the herniation side. The possible mechanisms of how contralateral symptoms predominate in these patients are also discussed. In all patients, the shape of disk herniations on imaging studies were quite similar: a broad-based posterior central-paracentral herniated disk with the apex deviated away from the side of the symptoms. The symptoms and signs resolved in the immediate postoperative period. Our data clears that sciatica can be caused by contralateral lumbar disk herniation. When operation is considered, intervention only from the herniation side is sufficient. It is probable that traction rather than direct compression is responsible from the emergence of contralateral symptoms.
Sucu
Hasan Kamil
HK
Department of Neurosurgery, Izmir Ataturk Research and Training Hospital, Izmir, Turkey. hsucu@yahoo.com
Gelal
Fazil
F
D000328:Adult; D019299:Decompression, Surgical / Q000379:methods; D017586:Diskectomy / Q000379:methods; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012585:Sciatica / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D013115:Spinal Canal / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013126:Spinal Nerve Roots / Q000293:injuries / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome