The Far Lateral Approach to Lumbar Disc Herniations

  • F. Porchet
  • H. Fankhauser
  • N. De Tribolet
Part of the Advances and Technical Standards in Neurosurgery book series (NEUROSURGERY, volume 23)


The diagnosis of extreme lateral lumbar disc herniation (ELLDH) as a cause of lumbar radiculopathy was first described by Abdullah in 1974 [1]. This discal pathology has been recognized for many years as an occasional cause of negative disc exploration and immediate failure of classical disc surgery in sciatica [1,18, 24, 25, 29, 31, 30, 31, 33, 35, 41]. Only since the introduction of computed tomography (CT) for the diagnosis of lumbar disc disease have the characteristics of ELLDH become fully appreciated [3, 6,13,17,23, 30,32,47]. Myelography alone was an insufficient diagnos- tic tool to detect this specific pathology. With the rapid development of neuroradiologic diagnostic imaging, including magnetic resonance imaging (MRI) [13, 32], recognition of this particular type of lumbar disc disease has increased its incidence, ranging from 0.7% to 11.7% of the total operated herniated discs [1, 22, 24, 45]. In a recent review of our series of patients with lumbar disc disease we found an overall incidence of ELLDH of 5.8% over a period of 8 years [38]. 78% of all ELLDH occured at the L4-L5 and L5-S1 levels, with an almost equal frequency, but the overall incidence of ELLDH per level varied relative to the level of the pathological disc.


Dorsal Root Ganglion Disc Herniation Facet Joint Lumbar Disc Spinal Nerve 
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Copyright information

© Springer-Verlag Wien 1997

Authors and Affiliations

  • F. Porchet
    • 1
  • H. Fankhauser
    • 1
  • N. De Tribolet
    • 1
  1. 1.Department of NeurosurgeryUniversity of LausanneSwitzerland

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