Original Articles: PDF OnlyForaminal and Extraforaminal Lumbar Disc Herniation: Diagnosis and TreatmentJACKSON, ROGER P., MD*; GLAH, JAMES J., DO†Author Information *From the North Kansas City Memorial Hospital, the University of Kansas School of Medicine, the Kansas University Medical Center Spine Surgery Fellowship Program, Kansas City, Missouri †From the Memorial Hospital, York, Pennsylvania Spine: July-August 1987 - Volume 12 - Issue 6 - p 577-585 Buy Abstract During a 1-year period from December 1, 1984, through November 30,1985, a total of 174 patients underwent lumbar discectomy for herniated nucleus pulposus. Eighteen (10.3%) were diagnosed as having foraminal or extraforaminal disc herniations. Sixteen patients are included in this study. All patients were evaluated with computed tomography, metrizamide myelography, discography, and discography-enhanced computed tomography (disco-CT). Accurate diagnosis of foraminal or extraforaminal herniation was made with disco-CT in 15 of 16 cases (93.8%), compared with discography alone (37.5%), computed tomography alone, and/or myelography-enhanced computed tomography (50%) and myelography alone (12.5%). Surgical treatment with bilateral hemilaminectomy, partial medial facetectomy, and partial internal foraminotomy, if needed, followed by discectomy is very effective and the favored surgical management for nerve root decompression in most all cases. © Lippincott-Raven Publishers.