A lumbar radiculopathy is often due to a herniated necleus pulposus. Different types of herniated disc are described: protrusion - herniated disc with broad-base at parent disc; extrusion - herniated disc with narrow or no base at parent disc; sequestered - free fragment; migrated - disc material displaced away from the site of herniation, regardless of continuity.
Most common location: L4-L5 and L5-S1. Age: 30 to 60 (mean: 40s).
A lumbar disc herniation causing radiculopathy refractory to at least 3 months of nonoperative therapy or causing progressive weakness, intractable pain, or cauda equina syndrome is appropriately treated by microsurgery. The surgical procedure is performed in order to decompress nerve roots from herniated disc material nd to avoid lumbar instability. Complications may include neural structure injury, instability, cerebrospinal fluid leaks, infections and, rarely, great vessel or intestinal injury. A good patient selection gives a good postoperative clinical result. Success rate ? 90%. 5% = failed back surgery syndrome.
Most common location: L4-L5 and L5-S1. Age: 30 to 60 (mean: 40s).
A lumbar disc herniation causing radiculopathy refractory to at least 3 months of nonoperative therapy or causing progressive weakness, intractable pain, or cauda equina syndrome is appropriately treated by microsurgery. The surgical procedure is performed in order to decompress nerve roots from herniated disc material nd to avoid lumbar instability. Complications may include neural structure injury, instability, cerebrospinal fluid leaks, infections and, rarely, great vessel or intestinal injury. A good patient selection gives a good postoperative clinical result. Success rate ? 90%. 5% = failed back surgery syndrome.
References
- 1.Javedan S, Sonntag VKH. Lumbar Disc Herniation: Microsurgical Approach. Neurosurgery 52(1):160-163, 2003.
- 2.Ross JS, Brant-Zawadzki M, Moore KR, et al.. Diagnostic Imaging Spine. First edition - Amirsys - Elsevier Saunders - 2004.
- 3.Handbook of Neurosurgery - fifth edition - Mark S. Greenberg - ed. Thieme.
