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EXTREME LATERAL DISC HERNIATIONS AND PARALATERAL DECOMPRESSION

  • Mahir GÜLŞEN
  • Gülşen BAYTOK
  • Serdar ÖZBARLAS

J Turk Spinal Surg 1994;5(3):121-124

Recent advances in imaging techniques have made possible to diagnose extreme lateral disc herniations more frequently. Herniated disc material causes to compression to root in the foramen. Majority of these herniations are seen at the L4-5 level, and characterized by sudden onset of severe leg pain. Back pain is usually minör. Straight leg raising is mildly positive, but femoral strecth test is highly positive. Conservative treatment usually fails in these patients. Surgical decompression is difficult by using classical hemilaminectomy. Because of herniated material is in the "hidden zone of Macnab"; it is necessary to perform complete facetectomy which is Undesi-rable. The paralateral muscle splitting approach enabtes surgeons to remove disc herniation without entering the spinal canal. İt saves pars interarticularis and the inferior facet. İn this paper, we vvould like to present two typical cases of extreme lateral disc herniations treated by paralateral approach.