Abstract
Between June 2007 and January 1998, we operated on 21 patients (13 men, 8 women, mean age 57 years) for sciatic pain caused caused by lateral lumbar disc herniation. In most cases, lateral fenestration under microscopic observation was done via the paraspinal approach of Wiltse.
We evaluated the morphology of the herniation with reference to the localization classification of Sannohe. Comparison of the localization classifications obtained by MRI with the operative findings, yielded an agreement rate of 57.1%. Furthermore, examination of the escape direction of the herniation showed that this occurred, craniad migration in 7 patients and at the intervertebral disc level in 14 patients. In patients with herniation directed cranially, the rate of agreement between the MRI localization classification and operative findings was 42.9%, whereas in those with herniation escape to the intervertebral disc level, the rate of agreement was 64.3%.
In cases of herniation directed cranially, we think that a new classification focusing on the relationship with the lateral part of the pars interarticularis is necessary.
