Far-lateral disc herniations: The results of conservative management

Merle S. Rust, William C. Olivero

Research output: Contribution to journalArticle

Abstract

The far-lateral herniated lumbar disc has become increasingly recognized as a cause for low back pain and lumbar radiculopathy as well as for 'failed back syndrome' in certain improperly diagnosed cases. Several authors have reported that the majority of patients show poor response to conservative measures. To better understand the natural history, we performed a retrospective review of all lumbar herniated discs during a 3-year period, collecting 16 patients with 17 far-lateral disc herniations. All displayed radicular pain in the distribution of the root exiting at the same level as the herniated disc, with or without associated back pain. Twelve of the 17 disc herniations responded to conservative measures and had complete resolution of their radicular pain at follow-up. Also, at long-term follow- up, essentially all patients had experienced satisfactory subjective resolution of their weakness or sensory complaints. Five patients required surgery because of intractable pain despite conservative measures. Although our series for far-lateral disc herniations is small, we found that conservative measures do afford a relatively high nonoperative success rate of ~71%. This is in contrast to earlier implied or stated opinions indicating a low rate of successful nonoperative management as low as 10% in one series.

Original languageEnglish (US)
Pages (from-to)138-140
Number of pages3
JournalJournal of Spinal Disorders
Volume12
Issue number2
StatePublished - Dec 1 1999

Keywords

  • Disc
  • Herniation
  • Management, conservative

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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