Clinical Features of Lateral Lumbar Disc Herniation.

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We evaluated the clinical findings of lateral lumbar disc herniation (LLDH) in four patients (three male and one female) whose mean age at the time of surgery was 39.3 years (range, 31-47 years). The L4 root was affected by L4-5 herniation in two patients, the L3 root by an L3-4 hernation in one, and the L5 root by an L5-S herniation in one. Operative findings were positive for foraminal disc herniation in three cases and for foraminal and extraforaminal disc herniation in one.Clinically, all patients had difficulty in walking and remaining supine. Four patients had sensory impairment and three showed muscular weakness. Femoral nerve stretch test was pisitive in two patients and straight leg raising test was positive in two.The patients were evaluated using the JOA score and compared with fourteen patients with intracanal lumbar disc herniation (ILDH) whose mean age at the time of operation was 39.6 years (range, 19-60). The average total JOA scores in LLDH and ILDH were 6.5 and 13.0 points, respectively (p<0.05). The scores of objective findings and activities of daily living were not significantly different between the two groups, however that of subjective findings in LLDH were significantly lower than in ILDH (p<0.01).
西日本整形・災害外科学会の論文